發(fā)布時間：2018-04-24 23:16

  本文選題：慢性阻塞性肺疾病 + IL-6�。� 參考：《河北醫(yī)科大學》2016年碩士論文

【摘要】：目的:探討白介素-6、降鈣素原、D-二聚體與慢阻肺急性加重期患者病情及預后相關(guān)性研究。方法:2014-11-01至2016--02-01于我院呼吸內(nèi)科因慢阻肺急性加重期、呼吸衰竭和肺性腦病入住呼吸重癥監(jiān)護室病例(簡稱重癥慢阻肺),所有患者均需氣管插管、有創(chuàng)通氣,共27例,其中男19例,女8例,平均年齡(72.96±8.89);因慢阻肺急性加重入住普通病房病例(簡稱普通慢阻肺),以上患者均無需有創(chuàng)通氣,共44例,其中男31例,女13例,平均年齡(68.20±11.09);及于我院體檢中心體檢的健康對照組12例,其中男8例,女4例,平均年齡(66.09±9.14),均簽署知情同意書。所有志愿者入院時均抽取患者外周靜脈血,應用免疫比濁法檢測志愿者血清D-二聚體水平,采用電化學發(fā)光法檢測檢測志愿者血清IL-6水平,發(fā)光免疫法檢測志愿者降鈣素原水平。應用SPSS13.0統(tǒng)計軟件收集及分析數(shù)據(jù)。對重癥慢阻肺組、普通慢阻肺及健康對照組三組數(shù)據(jù)行正態(tài)性檢驗,三組數(shù)據(jù)均符合正態(tài)分布,用均數(shù)±標準差((?)±s)描述,行方差齊性檢驗,方差齊,多樣本均數(shù)比較行完全隨機設(shè)計單因素方差分析,此后用SNK法進行兩兩比較,P0.05為差異具有統(tǒng)計學意義。在重癥慢阻肺患者中,死亡組與非死亡組之間比較,兩組數(shù)據(jù)均經(jīng)正態(tài)性檢驗,符合正態(tài)性,方差齊,用均數(shù)±標準差(x±s)描述,采用獨立樣本t檢驗,P0.05為差異具有統(tǒng)計學意義。結(jié)果:重癥慢阻肺患者血清IL-6水平(11.60±3.01)均高于普通慢阻肺患者(7.82±2.15)及健康對照組(4.63±1.78),三者間比較有統(tǒng)計學意義(F=39.16,P0.01)。重癥慢阻肺患者血清降鈣素原水平(0.46±0.08)均高于普通慢阻肺患者(0.12±0.06)及健康對照組(0.07±0.04),三者間比較有統(tǒng)計學意義(F=279.88,P0.01)。重癥慢阻肺患者血清D-二聚體水平(2.94±0.72)均高于普通慢阻肺患者(1.45±0.84)及健康對照組(0.86±0.53),三者間比較有統(tǒng)計學意義(F=43.51,P0.01)。在重癥慢阻肺患者中,死亡組血清IL-6水平(14.11±2.67)明顯高于非死亡組(10.35±2.36),兩組間比較有統(tǒng)計學意義(t=3.74,P0.01),死亡組血清降鈣素原水平(0.44±0.07)明顯高于非死亡組(0.52±0.08),兩組間比較有統(tǒng)計學意義(t=2.61,P0.05),死亡組(3.41±0.42)血清D-二聚體水平明顯高于非死亡組(2.71±0.74),兩組間比較有統(tǒng)計學意義(t=2.96,P0.01)。結(jié)論:入院時血清IL-6、降鈣素原、D-二聚體水平均與慢阻肺急性加重期患者病情嚴重程度及預后相關(guān)。
[Abstract]:Objective: to investigate the relationship between interleukin-6, procalcitonin D-dimer and patients with acute exacerbation of chronic obstructive pulmonary disease (COPD). Methods from 2014-11-01 to 2016-02-01, 27 patients with respiratory failure and pulmonary encephalopathy were admitted to the Respiratory intensive Care Unit (RICU) in the Department of Respiratory Medicine of our hospital for acute exacerbation of COPD. All the patients need tracheal intubation and invasive ventilation, including 19 males. There were 8 females (mean age 72.96 鹵8.89g), 44 patients (31 males, 13 females) who were admitted to the general ward for acute exacerbation of COPD. The average age was 68.20 鹵11.09, and 12 healthy controls were examined in the physical examination center of our hospital, including 8 males and 4 females, with an average age of 66.09 鹵9.14, all of whom signed informed consent. The peripheral venous blood was extracted from all the volunteers at admission. The serum levels of D-dimer and IL-6 were detected by immunoturbidimetry and electrochemiluminescence respectively. The level of procalcitonin in volunteers was detected by luminescent immunoassay. Collect and analyze data with SPSS13.0 software. The data of severe chronic obstructive lung group, common chronic obstructive lung group and healthy control group were tested for normality. The data of the three groups were all in accordance with normal distribution, described by mean 鹵standard deviation) 鹵s), and tested by homogeneity test of variance and homogeneity of variance. The analysis of variance of single factor of complete random design was carried out to compare the mean of multiple samples, and then the difference was statistically significant by using SNK method to compare pairwise and pairwise. In the patients with severe chronic obstructive pulmonary disease, the data of the two groups were compared between the death group and the non-death group. The data of the two groups were tested by normality, the variance was the same, and the mean 鹵standard deviation (x 鹵s) was used to describe the data. The difference was statistically significant by using independent sample t test (P0.05). Results: the level of serum IL-6 in patients with severe COPD was 11.60 鹵3.01) higher than that in patients with COPD (7.82 鹵2.15) and healthy controls (4.63 鹵1.78). The serum procalcitonin level in patients with severe COPD was 0.46 鹵0.08) higher than that in normal COPD patients (0.12 鹵0.06) and healthy controls (0.07 鹵0.04). The serum levels of D-dimer in patients with severe COPD were 2.94 鹵0.72) higher than those in patients with COPD (1.45 鹵0.84) and healthy controls (0.86 鹵0.53). In patients with severe COPD, The serum IL-6 level in the death group (14.11 鹵2.67) was significantly higher than that in the non-death group (10.35 鹵2.36). There was statistical significance between the two groups, and the serum procalcitonin level in the death group was 0.44 鹵0.07, which was significantly higher than that in the non-dead group (0.52 鹵0.08). There was significant difference between the two groups. The level of dimer was significantly higher than that of non-death group (2.71 鹵0.74), and the difference between the two groups was statistically significant. Conclusion: the levels of serum IL-6 and procalcitonin D-dimer on admission were correlated with the severity and prognosis of patients with acute exacerbation of COPD.
【學位授予單位】：河北醫(yī)科大學
【學位級別】：碩士
【學位授予年份】：2016
【分類號】：R563.9

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