【摘要】：目的:探討血清肺表面活性蛋白D(surfactant protein D,SP-D)、降鈣素原(procalcitonin,PCT)、C-反應(yīng)蛋白(C-reactive protein,CRP)三種血清學(xué)炎癥標(biāo)志物濃度變化與慢性阻塞性肺疾病(chronic obstructive pulmonary disease,COPD)的關(guān)系,尋找一種高效敏感的血清炎癥標(biāo)志物,指導(dǎo)慢性阻塞性肺疾病急性加重期(acute exacerbations of chronic obstructive pulmonary disease,AECOPD)患者抗炎藥物應(yīng)用和肺功能分級。方法:選擇40例AECOPD患者,COPD穩(wěn)定期患者40例為試驗(yàn)組,其中,AECOPD組患者中有20例肺功能分級為GOLD1~2級,20例肺功能分級為GOLD3~4級,健康體檢者40例為對照組,檢測三種血清學(xué)標(biāo)志物水平。結(jié)果:1、AECOPD組、COPD穩(wěn)定期組、健康血清血清SP-D水平分別為(24.19±2.67)ng/L、(20.77±1.17)ng/L、(18.84±1.11)ng/L;PCT水平為(714.28±185.73)ng/L、(405.38±43.63)ng/L、(388.28±34.24)ng/L;CRP水平為(52.45±9.54)mg/L、(8.72±2.65)mg/L、(7.85±2.24)mg/L,COPD穩(wěn)定期組和健康對照組血清SP-D、PCT、CRP濃度明顯低于AECOPD組,差異均有統(tǒng)計學(xué)意義(P0.05),血清PCT、CRP水平在COPD穩(wěn)定期組高于健康對照組,但差異無統(tǒng)計學(xué)意義(P0.05),2.SP-D水平在AECOPD GOLD 1~2級組(22,15±1.71)ng/L低于GOLD3~4級組(26.23±1.77)ng/L,差異明顯有統(tǒng)計學(xué)意義(P0.05)。3.AECOPD組患者SP-D水平與PCT呈正相關(guān)性(相關(guān)系數(shù)r=0.333,P0.05),但與CRP無相關(guān)性(r=-0.284,P0.05),PCT與CRP也無相關(guān)性(r=0.016,P0.05)。結(jié)論:1.血清SP-D、PCT、CRP在COPD急性加重期明顯升高,COPD穩(wěn)定期SP-D有所下降,SP-D、PCT、CRP是反映COPD急性加重的炎癥指標(biāo)。2.AECOPD患者血清SP-D水平可以反應(yīng)氣道阻塞嚴(yán)重程度,指導(dǎo)臨床醫(yī)生選擇吸入制劑的應(yīng)用。3.血清SP-D與PCT水平在COPD急性加重期表現(xiàn)為正相關(guān)性,而與CRP卻無相關(guān)性,PCT與CRP也無相關(guān)性。
[Abstract]:Objective: To study the relationship between serum pulmonary surfactant protein D (SP-D), procalcitonin (PCT), C-reactive protein (CRP) and chronic obstructive pulmonary disease (COPD). To find an effective and sensitive serum inflammatory marker to guide the application of anti-inflammatory and pulmonary function in patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD). Methods:40 patients with AECOPD and 40 patients with stable COPD were selected as the test group, among which,20 of the patients with AECOPD were classified as GOLD1-2,20 cases of lung function were classified as GOLD3-4, and 40 healthy subjects were control group, and the level of three serological markers was detected. Results: The levels of SP-D were (24.19-2.67) ng/ L, (20.77-1.17) ng/ L, (18.84-1.11) ng/ L, (714.28-185.73) ng/ L, (405.38-43.63) ng/ L, (388.28-34.24) ng/ L, and CRP levels (52.45-9.54) mg/ L, (8.72-2.65) mg/ L, respectively. (7.85-2.24) mg/ L, the concentrations of SP-D, PCT and CRP in the stable and healthy controls were significantly lower than those in the AECOPD group (P0.05). The level of SP-D in the AECOPD group was lower than that of the GOLD3-4 group (26.23-1.77) ng/ L (P <0.05). The SP-D level in the AECOPD group was positively correlated with PCT (r = 0.333, P0.05), but not related to CRP (r =-0.284, P0.05). There was no correlation between PCT and CRP (r = 0.016, P0.05). Conclusion:1. Serum SP-D, PCT, and CRP were significantly elevated in the acute exacerbation of COPD, and the SP-D in the stable period of COPD decreased, and SP-D, PCT and CRP were the index of inflammation that reflected the acute exacerbation of COPD. Serum SP-D and PCT level showed positive correlation in acute exacerbation of COPD, and there was no correlation with CRP, and there was no correlation between PCT and CRP.
【學(xué)位授予單位】：蚌埠醫(yī)學(xué)院
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R563.9

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