本文選題：慢性阻塞性肺疾病 + 胰石蛋白　； 參考：《遵義醫(yī)學(xué)院》2017年碩士論文

【摘要】：目的:觀察血清胰石蛋白(PSP/Reg)在COPD急性期、緩解期及健康體檢者中的表達(dá)情況,探討血清胰石蛋白在慢性阻塞性肺疾病急性加重期患者診療中的臨床意義。方法:選取75名急性期COPD患者作為A組,將A組按病情由輕到重分為輕(A1組)、中(A2組)、重(A3組)三組。將A組經(jīng)治療后癥狀緩解者作為R組,將R組由輕到重分為R1、R2、R3三組。26名健康體檢者作為對(duì)照組(H組),將A組中痰培養(yǎng)陽(yáng)性者作為S組,將S組中癥狀緩解后痰培養(yǎng)轉(zhuǎn)陰者作為S1組。收集研究對(duì)象年齡、性別、CAT評(píng)分,收集A、R、H組空腹靜脈血,測(cè)定血清PSP/Reg濃度。測(cè)定A組入院當(dāng)天的降鈣素原(PCT)、C-反應(yīng)蛋白(CRP)、白介素-6(IL-6)、紅細(xì)胞沉降率(ESR)、白細(xì)胞計(jì)數(shù)(WBC)、中性粒細(xì)胞計(jì)數(shù)(N)及痰培養(yǎng),痰培養(yǎng)陽(yáng)性者達(dá)到臨床明顯緩解后再次行痰培養(yǎng)檢查。待病情平穩(wěn)后測(cè)定肺功能。觀察A組、S組中PSP/Reg與PCT、CRP、IL-6、ESR、WBC、N的相關(guān)性。結(jié)果:急性期的A組血清PSP/Reg水平顯著高于癥狀緩解后的R組,差異有統(tǒng)計(jì)學(xué)意義(P0.05);急性期的A組及緩解后的R組血清PSP/Reg水平顯著高于健康對(duì)照H組,差異有統(tǒng)計(jì)學(xué)意義(P0.05);急性期血清PSP/Reg水平在A1、A2、A3各組間差異顯著(P0.05),且呈遞增趨勢(shì);A2、A3、S組經(jīng)治療后,血清PSP/Reg水平下降明顯,差異有統(tǒng)計(jì)學(xué)意義(P0.05);急性期血清PSP/Reg水平與CRP正相關(guān)(P0.05),與其他指標(biāo)無(wú)相關(guān)性(P0.05)。痰培養(yǎng)陽(yáng)性組血清PSP/Reg水平與CRP呈正相關(guān)(P0.05)。結(jié)論:血清PSP/Reg有可能可作為評(píng)估肺部炎性感染的指標(biāo),與PCT、CRP等炎性指標(biāo)聯(lián)合使用有更好的診斷價(jià)值;血清PSP/Reg有可能可作為AECOPD病情評(píng)估的有效指標(biāo)之一,與肺功能、臨床癥狀、急性加重情況聯(lián)合使用更有助于患者病情的評(píng)估;血清PSP/Reg水平在治療前后存在顯著差異,可能有助于疾病治療效果的評(píng)估。
[Abstract]:Objective: To observe the clinical significance of serum trypsin (PSP/Reg) in patients with acute COPD, remission and health examination, and to explore the clinical significance of serum trypsin in the diagnosis and treatment of acute exacerbation of chronic obstructive pulmonary disease. Methods: 75 patients with acute COPD were selected as A group, and group A was divided into light (A1) from light to weight (A2). Group A (group A3) three groups. Group A was treated as R group after treatment, and group R from light to heavy to R1, R2, R3 in group.26 name as control group (H group). The sputum culture positive in A group was taken as S group. Fasting venous blood, determination of serum PSP/Reg concentration. Determination of calcitonin (PCT), C- reactive protein (CRP), -6 (IL-6), erythrocyte sedimentation rate (ESR), leukocyte count (WBC), neutrophils count (N) and sputum culture in A group. The sputum culture of sputum culture positive patients after clinical obvious remission. The correlation between PSP/Reg and PCT, CRP, IL-6, ESR, WBC, N in group A and group S was observed. Results: the serum PSP/Reg level in the acute phase of the A group was significantly higher than that of the R group after the symptom remission. The levels of serum PSP/Reg in the acute phase of A1, A2, and A3 were significantly different (P0.05) and increased, and the level of serum PSP/Reg decreased significantly in A2, A3, S group after treatment, the difference was statistically significant (P0.05), and there was no correlation between the serum PSP/Reg level and the other indexes in the acute stage. Positive correlation with CRP (P0.05). Conclusion: serum PSP/Reg may be used as an indicator of pulmonary inflammatory infection and is of better diagnostic value combined with PCT, CRP and other inflammatory markers. Serum PSP/Reg may be one of the effective indicators for the assessment of AECOPD, and is more helpful to the combined use of lung power, clinical symptoms and acute exacerbation. There is a significant difference in serum PSP/Reg level before and after treatment, which may be helpful to evaluate the therapeutic effect of the disease.
【學(xué)位授予單位】：遵義醫(yī)學(xué)院
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類(lèi)號(hào)】：R563.9

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