COPD机械通气患者肺泡灌洗液中SP-D、IL-6的监测及临床意义  

Monitoring and its clinical significance of SP-D and Interleukin-6 levels in the bronchoalveolar lavage fluid of COPD patients undergoing mechanical ventilation

作　　者：翁婷[1] 周玉皆[1] 王丽芳[2] 施斌[2] 

机构地区：[1]南京大学医学院临床学院附属鼓楼医院呼吸科,江苏南京210008 [2]南京鼓楼医院集团宿迁市人民医院呼吸内科,江苏宿迁223800

出　　处：《临床肺科杂志》2014年第8期1386-1388,共3页Journal of Clinical Pulmonary Medicine

摘　　要：目的观察COPD机械通气患者肺泡灌洗液(BALF)中肺表面活性物质相关蛋白D(SP-D)及白介素-6(IL-6)的水平。方法 40例COPD机械通气患者根据入院第ld和第5d的APACHE II评分变化,分为病情加重组(17例),及病情缓解组(23例),收集机械通气1、5d的肺泡灌洗液,测定BALF中SP-D、IL-6浓度,观察不同预后患者BALF中SP-D、IL-6水平的差异。结果病情缓解组BALF中SP-D含量逐渐上升,机械通气5d较1d明显升高(P<0.05);与病情缓解组比较,病情加重组机械通气1d、5d BALF中SP-D含量均明显降低(P<0.05)。病情缓解组BALF中IL-6含量逐渐下降,病情加重组BALF中IL-6含量逐渐上升(P<0.05)。相关分析显示BALF中SP-D浓度与IL-6含量及APACHE II评分均呈负相关性(r分别为-0.35,-0.41,均P<0.05)。结论 SP-D、IL-6在COPD患者的发生发展中起重要的作用,BALF中SP-D、IL-6可作为COPD机械通气患者病情监测和预后的参考指标。Objective To investigate the concentration of pulmonary surfactant-associated protein D（ SP-D）and interleukin-6（ IL-6） in the bronchoalveolar lavage fluid（ BALF） of COPD patients undergoing mechanical ventilation（ MV）. Methods 40 patients with COPD undergoing MV were involved in the study. According to the APACHE II score,the patients were divided into the remission group（ n = 23） and the worsening group（ n = 17）.BALF was collected on the 1st and 5th days after MV. The content of IL-6 and SP-D in BALF was measured by ELISA. The levels of IL-6 and SP-D in BALF of the patients with different severity were compared. Results The level of SP-D was significantly higher on the 5th day than on the 1st day in the remission group,and it decreased more obviously in the worsening group（ P〈0. 05）. The level of IL-6 decreased gradually in the remission group but increased gradually in the worsening group. The level of SP-D was negatively correlated with IL-6 level and APACHE II score. Conclusion The findings suggest that the levels of SP-D and IL-6 in BALF are correlated with prognosis of COPD patients undergoing MV,and it may prove to be useful as a guidance of therapy and prognosis.

关 键 词：COPD 机械通气 肺泡灌洗液 SP-D IL-6 

分 类 号：R563.9[医药卫生—呼吸系统]