高原地区慢性肺心病患者血清和诱导痰中hs-CRP浓度的变化及意义  

Levels of high sensitive c-reactive protein and its clinical significance in the patients with chronic cor pulmonale at high altitude

作　　者：冯恩志[1] 杨生岳[1] 郭振援[1] 王绍林[1] 赵丽红[1] 张瑛[1] 刘睿年[1] 陈宗茹[1] 

机构地区：[1]解放军第四医院兰州军区呼吸内科中心,青海西宁810007

出　　处：《临床肺科杂志》2010年第12期1741-1743,共3页Journal of Clinical Pulmonary Medicine

摘　　要：目的探讨高原地区慢性肺心病患者血清和诱导痰中高敏-C反应蛋白(hs-CRP)浓度的变化及临床意义。方法高原慢性肺心病急性加重期患者50例(A组)、缓解期患者47例(B组),健康对照组40例(C组),分别测血清和诱导痰中hs-CRP、1秒钟用力呼气容积(FEV1)占预计值的百分比(FEV1%)、FEV1/用力肺活量(FVC)比值(FEV1/FVC)、动脉血氧分压(PaO2)和动脉血二氧化碳分压(PaCO2)。结果 A、B组血清和诱导痰中hs-CRP、PaCO2[分别为(12.27±2.21)mg/L、(52.36±6.30)mg/L、(58.3±6.4)mmHg和(7.54±1.25)mg/L、(22.78±3.16)mg/L、(45.3±5.4)mmHg]显著高于C组[分别为(2.19±0.51)mg/L、(4.66±0.63)mg/L、(30.55±5.3)mmHg,P均<0.01],FEV1%、FEV1/FVC、PaO2[分别为(36.2±6.7)%、(41.3±5.2)%、(36.4±5.2)mmHg和(42.5±5.7)%、(49.8±5.6)%、(48.7±6.1)mmHg]显著低于C组[分别为(79.8±5.3)%、(81.6±6.0)%、(68.2±4.3)mmHg,P均<0.01];A组与B组之间比较差异有统计学意义(P均<0.01);A、B组诱导痰中hs-CRP水平均显著高于血清(P均<0.01)。A、B组血清和诱导痰中hs-CRP与FEV1%、FEV1/FVC、PaO2呈显著负相关(P均<0.01),与PaCO2呈显著正相关(P均<0.01)。结论 hs-CRP参与了高原慢性肺心病患者的气道炎症反应,且其体内也存在系统性炎症反应;检测hs-CRP水平变化,可作为病情和疗效判断的有效指标。Objective To investigate the Levels of high sensitive c-reactive protein（hs-CRP） and its clinical significance in the patients with chronic cor pulmonale at high altitude（HACCP）.Methods 50 patients in acute stage of HACCP（A group） and 47 patients in remission stage（B group） were included.40 healthy volunteers were used as controls（C group）.Their serous level of serum and induced sputum hs-CRP,forced expiratory volume in 1 second（FEV1） expressed as percentage predicted（FEV1%）,and ratio of FEV1 to forced vital capacity（FEV1 /FVC）,partial pressure of arterial O2（PaO2） and partial pressure of arterial CO2（PaCO2） were measured.Results Level of serum and induced sputum hs-CRP,PaCO2 in group A and group B[（12.27 ± 2.21） mg/L,（52.36 ± 6.30） mg/L,（58.3 ±6.4） mmHg and（7.54 ± 1.25） mg/L,（22.78 ± 3.16） mg/L,（45.3 ± 5.4） mmHg,respectively]were significantly higher than those in group C[（2.19 ± 0.51） mg/L,（4.66 ± 0.63） mg/L,（30.55 ± 5.3） mmHg,respectively,all P 0.01],and FEV1%,FEV1 /FVC and PaO2[（36.2 ± 6.7） %,（41.3 ± 5.2） %,（36.4 ± 5.2） mmHg and（42.5 ± 5.7） % 、（49.8 ± 5.6） %,（48.7 ± 6.1） mmHg,respectively]were significantly lower than those in group C[（79.8 ± 5.3） %,（81.6 ± 6.0） %,（68.2 ± 4.3） mmHg,respectively,all P 0.01]）,there were significantly differences between the in group A and group B（all P 0.01）.Level of induced sputum hs-CRP was significantly higher than this of serum in group A and group B（all P 0.01）.Level of serum and induced sputum hs-CRP in group A and group B was negatively correlated with FEV1%,FEV1 /FVC and PaO2（all P 0.01）,but was positively correlated with PaCO2（all P 0.01）.Conclusion hs-CRP may participat in pathogenesis of airway inflammatory process of HACCP,systemic inflammatory process is present in patients with HACCP.They can be used as the indicators of pathogenetic condition and therapeutic effects.

关 键 词：肺疾病 阻塞性 肺心病 高敏-C反应蛋白 高原 

分 类 号：R541.5[医药卫生—心血管疾病]