摘要
目的:探究急性支气管炎患者C反应蛋白清除率(C-reactive protein clearance rate,CRPc)与气道高反应性(airway hyperresponsiveness,AHR)的相关性,以期为临床诊断急性支气管炎患者AHR程度提供参考依据。方法:选取2020年6月~2023年6月泸州市中医医院收治的急性支气管炎患者182例作为研究对象,根据AHR程度不同将患者分为A组:轻度(n=67)、B组:中度(n=59)、C组:重度(n=56)。采用1∶1倾向性匹配的方法调整患者资料的均衡性。所有患者均进行肺部检查,采集患者清晨空腹血,应用ELISA法检测患者血清指标,C反应蛋白(C-reactive protein,CRP)水平分别于患者入院24 h内及治疗后3、5、7 d检测,通过计算获得相应的CRPc。多因素Logistic回归分析CRPc与AHR程度的相关性,分析影响AHR程度的临床因素,构建相应预测模型并进行评价。结果:3组治疗前各项指标无统计学差异。治疗后3组患者1 s用力呼气容积(forced expiratory volume in the first second,FEV 1)/用力肺活量(forced vital capacity,FVC)、每分钟最大通气量(maximum voluntary ventilation,MVV)、γ-干扰素(interferon-γ,IFN-γ)、白细胞介素-10(interleukin-10,IL-10)和FEV 1下降20%激发剂累计含量(provocation dosage when FEV 1 is reduced by 20%,PD 20 FEV 1)水平升高,CRP、人软骨糖蛋白39(human cartilage glycoprotein 39,YKL-39)和白三烯E4(leukotriene E4,LTE4)水平降低,改善效果显著,且A组患者一秒率(FEV 1/FVC)、MVV、IFN-γ、IL-10、PD 20 FEV 1水平高于其他2组,CRP、YKL-39、LTE4水平低于其他2组,改善效果较好。3组患者的CRPc-7分别为(70.66±14.85)%、(60.55±15.52)%和(48.24±14.47)%,A组患者CRPc显著高于其他2组。多因素Logistic回归分析结果显示CRPc-3(OR=0.85,95%CI:0.69~0.87)、CRPc-5(OR=0.92,95%CI:0.77~0.95)、CRPc-7(OR=0.96,95%CI:0.89~0.98)与患者AHR程度存在相关性。YKL-39和LTE4是患重症AHR的危险因素(OR>1),CRPc-3、CRPc-5、CRPc-7、IFN-γ和PD 20 FEV 1是患重症AHR的保护因素(OR
Objective:To explore the correlation between C-reactive protein clearance rate(CRPc)and airway hyperresponsiveness(AHR)in acute bronchitis patients,in order to provide a reference for clinical diagnosis of AHR degree in acute bronchitis patients.Methods:A total of 182 patients with acute bronchitis admitted to Luzhou Hospital of Traditional Chinese Medicine from June 2020 to June 2023 were selected as the study objects,and were divided into group A:mild(n=67),group B:moderate(n=59),and group C:severe(n=56)according to the different degrees of AHR.The method of 1∶1 orientation matching was used to adjust the balance of patient data.All patients underwent lung examination,fasting blood was collected in the morning,and serum indexes of patients were detected by enzyme-linked immunosorbent assay.CRP level and CRPc were detected within 24 h and after admission and 3,5,and 7 d after treatment.Multivariate Logistic regression analysis was conducted to analyze the correlation between CRPc and AHR degree,analyze the clinical factors affecting AHR degree,construct the corresponding prediction model and evaluate.Results:After 1∶1 orientation matching,47 patients with mild,moderate and severe AHR with no statistical difference in various indicators before treatment were obtained.After treatment,the levels of FEV 1/FVC,MVV,interferon-γ(IFN-γ),IL-10 and PD 20 FEV 1 in the 3 groups were increased,while the levels of CRP,YKL-39 and LTE4 were decreased,indicating a significant improvement effect.In addition,the levels of FEV 1/FVC,MVV,IFN-γ,IL-10 and PD 20 FEV 1 in group A were higher than those in the other two groups,while the levels of CRP,YKL-39 and LTE4 were lower than those in the other two groups,and the improvement effect was better.The CRPc of group A,B and C after 7 d of treatment were(70.66±14.85)%,(60.55±15.52)%and(48.24±14.47)%,respectively,and the CRPc of group A were significantly higher than those of the other two groups.Multivariate Logistic regression analysis showed that CRPc-3(OR=0.85,95%CI:0.69-0.87
作者
徐伟
程继夏
李洁
张华
XU Wei;CHENG Jixia;LI Jie;ZHANG Hua(Department of Respiratory and Critical Care Medicine,Luzhou Hospital of Traditional Chinese Medicine,Luzhou 646000,Sichuan,China;Hepatobiliary Surgery,Luzhou Hospital of Traditional Chinese Medicine,Luzhou 646000,Sichuan,China)
出处
《暨南大学学报（自然科学与医学版）》
CAS
北大核心
2024年第5期502-511,共10页
Journal of Jinan University(Natural Science & Medicine Edition)
基金
四川省中医药科研专项课题(2023MS303)。
关键词
急性支气管炎
C反应蛋白
C反应蛋白清除率
气道高反应性
acute bronchitis
C-reactive protein
C-reactive protein clearance rate
airway hyperresponsiveness
