慢性阻塞性肺病C-反应蛋白与内皮促凝血活化因子变化研究  

Study of C - reactive protein and markers of endothelial - coagulative activation in patients with chronic obstructive pulmonary disease

作　　者：冯健[1] 倪松石[1] 周娟[1] 顾俊[1] 

机构地区：[1]南通大学附属医院呼吸科,江苏省南通226001

出　　处：《中华航海医学与高气压医学杂志》2009年第5期284-287,共4页Chinese Journal of Nautical Medicine and Hyperbaric Medicine

摘　　要：目的探讨慢性阻塞性肺疾病（COPD）急性加重期患者血清C-反应蛋白（C—reactive protein，CRP）、血管性血友病因子抗原（von Willebrand factorantigen，vwF：Ag）、凝血因子Ⅰ即纤维蛋白原（fibrinogen，Fbg）、抗凝血酶（antithrombin，AT）-Ⅲ，D-二聚体的含量、活性的变化及其临床意义。方法检测40例COPD患者急性加重期、稳定期及20例健康体检者（对照组）血清CRP、内皮细胞活化产物vWF：Ag、凝血因子Fbg、抗凝因子AT-Ⅲ、纤维蛋白降解产物D-二聚体的含量，同时进行肺功能和动脉血气测定。结果COPD患者急性加重期血清CRP、vwF：Ag、Fbg、D-二聚体水平较稳定期及对照组均明显升高，稳定期水平较对照组明显升高，差异有统计学意义（P〈0．05或P〈0．01）；COPD患者血清CRP、vWF：Ag、Fbg及D-二聚体水平与第1秒用力呼气容积与用力肺活量的比值（FEV1／FVC）呈负相关，而CRP与各个促凝指标呈正相关；AT-Ⅲ各组间差异无统计学意义（P〉0．05）。结论COPD急性加重期的系统性炎症反应与内皮-促凝系统的激活有关，监测CRP、vWF：Ag、Fbg、D-二聚体表达对患者病情、疗效判断，预测预后及指导临床用药有一定价值。Objective To investigate the content, activity changes and clinical significance of C- reactive protein （CRP）, von Willebrand factor antigen （vWF：Ag）, fibrinogen （Fbg）, antithrombin （AT）-Ⅲ and D-dimer in chronic obstructive pulmonary disease （ COPD ） patients with acute exacerbation. Methods Levels of serum CRP, endothelial cell activation product vWF： Ag, coagulation factor Fbg, anticoagulant factor AT-Ⅲ and fibrin degradation product D-dimer were detected in 40 cases of COPD patients at either acute exacerbation or stable stages and 20 healthy cases （as control ）. Pulmonary function and arterial blood gas analysis were determined at the same time. Results Levels of serum CRP, vWF： Ag, Fbg and D-dimer in COPD patients at acute exacerbation stage were significantly higher than those of the stable patients and the control. Levels of those compounds at stable stage were significantly higher than those of the control group, indicating a statistical significance （ P 〈 0.05 or P 〈 0.01 ）. Serum CRP, vWF ： Ag, Fbg, and D-dimer levels of COPD patients were negatively correlated with forced expiratory volume in percentages of one second/forced vital capacity （FEV1/FVC）, while CRP was positively correlated with various procoagulant indicators. No statistical difference could be noted in AT-Ⅲ between the groups （ P 〉 0. 05 ）. Conclusions Systemic inflammatory response of COPD patients in acute exacerbation was correlated with the activation of endothelialcoagulative system. Detection of CRP, vWF： Ag, Fbg and D-dimer had certain significance in the understanding of pathogenesis, the monitoring of therapeutic effect, prognosis and the application of clinical medication as well.

关 键 词：肺疾病 慢性阻塞性 C-反应蛋白 血管性血友病因子 纤维蛋白原 D-二聚体 

分 类 号：R563[医药卫生—呼吸系统]