本文選題：肺疾病　切入點：慢性阻塞性　出處：《安徽醫(yī)科大學》2017年碩士論文　論文類型：學位論文

【摘要】：目的通過檢測慢性阻塞性肺疾病急性加重期(AECOPD)患者治療前后血清高敏肌鈣蛋白T(hs-c Tn T)、心型脂肪酸結(jié)合蛋白(H-FABP)表達水平的變化,探討它們在AECOPD患者心臟功能早期損害中的臨床意義。方法對2015年12月至2016年6月我科110例慢性阻塞性肺疾病急性加重期住院患者進行研究,符合入組條件患者80例,其中輕、中度組35例、重度、極重度組45例,同期40例門診體檢者為對照組。收集一般臨床資料,分別采用電化學發(fā)光法測定血清hs-c Tn T、酶聯(lián)免疫吸附法測定血清H-FABP,并進行動脈血氣、血清AST、LDH、CK、CKMB、c Tn I、肌紅蛋白測定,所有受試者進行肺功能檢查。比較分析各組間一般資料及血清學心肌損傷指標。同時,所有AECOPD患者依據(jù)GOLD2015年指南推薦,均接受正規(guī)內(nèi)科治療,AECOPD患者病情穩(wěn)定狀態(tài)下對其進行上述相關指標的復測。結(jié)果與對照組相比,AECOPD組hs-c Tn T及H-FABP的表達量均顯著增高(P0.001);與治療前相比,輕、中度AECOPD組治療后hs-c Tn T表達量輕度降低,差異無統(tǒng)計學意義(P0.05),H-FABP表達量顯著降低,差異具有統(tǒng)計學意義(P0.01);重、極重度AECOPD組治療后的hs-c Tn T和H-FABP表達量較治療前均顯著降低,差異有統(tǒng)計學意義(P0.01);c Tn I、AST、LDH、CK、CKMB、肌紅蛋白表達量于治療前后比較均無統(tǒng)計學意義(P0.05)。結(jié)論與傳統(tǒng)的心肌指標相比較,血清hs-c Tn T和H-FABP對于早期判斷AECOPD患者心肌損傷可能具有重要的臨床價值,對進行早期臨床干預具有指導意義。
[Abstract]:Objective to investigate the changes of serum troponin TnTn and cardiac fatty acid binding protein (H-FABP) in patients with acute exacerbation of chronic obstructive pulmonary disease (COPD) before and after treatment. Methods from December 2015 to June 2016, 110 inpatients with acute exacerbation of chronic obstructive pulmonary disease (COPD) in our department were studied. 35 cases in moderate group, 45 cases in severe group, 45 cases in severe group and 40 cases in outpatient examination group as control group. General clinical data were collected, serum hs-c TN T was measured by electrochemiluminescence method, serum H-FABP was measured by enzyme-linked immunosorbent assay (Elisa), and arterial blood gas was performed. Serum ASTX LDHK CKMBC T n I, myoglobin, pulmonary function tests were performed in all subjects. General data and serum myocardial injury indexes were compared and analyzed among the groups. Meanwhile, all AECOPD patients were recommended according to the GOLD2015 year guidelines. Results the expression of hs-c TNT and H-FABP in AECOPD group was significantly higher than that in control group (P 0.001). After treatment, the expression of hs-c TNT and H-FABP in moderate AECOPD group was slightly decreased, but there was no significant difference in the expression of H-FABP between the two groups (P 0.05), the difference was statistically significant (P 0.01), the expression of hs-c TNT and H-FABP in very severe AECOPD group was significantly lower than that before treatment, and the expression of TnT and H-FABP in severe AECOPD group was significantly lower than that before treatment. The difference was statistically significant (P 0.01). The expression of myoglobin was not significantly different between before and after treatment. Conclusion compared with the traditional myocardial indexes, the expression of myoglobin in CKMBs was not significantly different from that of the traditional myocardial indexes, and there was no significant difference in the expression of myoglobin between the two groups before and after treatment. Serum hs-c TNT and H-FABP may have important clinical value in early diagnosis of myocardial injury in patients with AECOPD, and have guiding significance for early clinical intervention.
【學位授予單位】：安徽醫(yī)科大學
【學位級別】：碩士
【學位授予年份】：2017
【分類號】：R563.9

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