摘要
目的观察慢性阻塞性肺疾病(简称慢阻肺)急性加重患者血浆Clara细胞分泌蛋白(CC16)的动态变化,探讨其在疾病发生发展过程中的作用与临床意义。方法慢阻肺急性加重患者71例作为观察组,于入院后第1天和第7天完成CAT评分及采取静脉血2 ml,并记录患者第1秒用力呼气容积占预计值百分比(FEV_1%pred)、用力肺活量占预计值百分比(FVC%pred)、FEV_1和FVC的比值(FEV_1/FVC)、动脉血二氧化碳分压(PaCO_2)、白细胞计数(WBC)、中性粒细胞百分比(NEUT%)、C反应蛋白(CRP)、降钙素原(PCT)、住院时间。健康成年人20例作为对照组,采取静脉血2 ml。检测比较两组血浆CC16水平及其动态变化,并分析其与CAT评分、住院时间的相关性。结果慢阻肺急性加重患者血浆CC16水平较对照组显著降低,肺功能明显低于健康对照组,WBC、NEUT%较健康对照组均明显升高,差异均具有统计学意义(P<0.05)。与入院第1天相比,慢阻肺急性加重患者入院第7天的血浆CC16水平、CAT评分、PaCO_2、WBC、NEUT%、CRP、PCT均明显降低,差异均有统计学意义(P<0.05)。慢阻肺急性加重患者血浆CC16水平与其CAT评分呈负相关(r=–0.704,P<0.001),与住院时间呈负相关(r=–0.351,P=0.003)。结论 CC16参与慢阻肺急性加重的发生发展过程,并与疾病的严重程度及预后密切相关,其动态变化可用于预测慢阻肺急性加重患者的病情变化及评估其临床治疗效果,结合临床常用指标综合分析可缩短住院时间。
Objective To observe the dynamic changes of plasma Clara cell secretory protein(CC16) in patients with acute exacerbation of chronic obstructive pulmonary disease(AECOPD), and to explore its role in the occurrence and development of the disease and clinical significance. Methods A total of 71 AECOPD patients were included in this study as observation group. All subjects completed the CAT questionnaire and were sampled 2 ml of venous blood on day1 and day 7 after their admission. And the percentage of forced expiratory volume in the first second(FEV1% pred),percentage of forced vital capacity in the estimated value(FVC%pred), FEV1/FVC ratio, arterial partial pressure of carbon dioxide(PaCO2), white blood cell count(WBC), the proportion of neutrophils(NEUT%), C-reactive protein(CRP),procalcitonin(PCT) and the length of stay of subjects were recorded. Another 20 healthy adults were enrolled as the control group. Each subject of the control group was sampled 2 ml of venous blood. The plasma CC16 levels of the two groups were tested and compared, and analyzed its correlation with CAT score and length of stay. Results The plasma CC16 level of AECOPD patients was significantly lower than that of the control group, lung function was significantly lower than that of the healthy control group, WBC and NEUT% were significantly higher than that of the healthy control group, and the difference was statistically significant(P<0.05). Compared with day 1 after admission, the plasma CC16 level, CAT score, PaCO2, WBC, NEUT%, CRP, PCT of AECOPD patients on day 7 were significantly decreased, with statistically significant differences(P<0.05). The plasma CC16 level of AECOPD patients was negatively correlated with their CAT score(r=–0.704, P<0.001), and also was negatively correlated with the length of stay(r=–0.351, P=0.003).Conclusions CC16 is involved in the development and progression of AECOPD and closely related to the severity and prognosis of the disease. Its dynamic changes can predict the condition changes and evaluate
作者
马青
王导新
MA Qin;WANG Daoxin(Department of Respiratory and Critical Care Medicine,The Second Affiliated Hospital of Chongqing Medical University,Chongqing 400010,P.R.China)
出处
《中国呼吸与危重监护杂志》
CAS
CSCD
北大核心
2019年第2期115-119,共5页
Chinese Journal of Respiratory and Critical Care Medicine
基金
国家自然科学基金(81670071)
关键词
CLARA细胞分泌蛋白
慢性阻塞性肺疾病
急性加重
动态变化
临床意义
Clara cell secretory protein
Chronic obstructive pulmonary disease
Acute exacerbation
Dynamic changes
Clinical significance
