炎性生物标志物对慢性阻塞性肺疾病患者死亡的影响  

Effect of inflammatory biomarkers on death of patients with chronic obstructive pulmonary disease

作　　者：李红燕[1] 

机构地区：[1]河南省安阳市人民医院呼吸内科,455000

出　　处：《中国综合临床》2014年第10期1038-1040,共3页Clinical Medicine of China

摘　　要：目的 探讨相关炎性生物标志物与慢性阻塞性肺疾病（COPD）患者死亡的相关性,为临床筛查高危病例提供依据.方法 2012年3月至2013年2月门诊和住院的COPD稳定期患者1 500例,随访15～27个月,以15个月截止,根据患者生存与死亡情况分组：死亡组154例,生存组1 346例.观察和比较两组病例临床资料、肺功能水平、呼吸困难程度和炎性生物标志物水平.结果 死亡组病例平均年龄（65.3±12.2）岁,显著高于生存组（60.2±11.5）岁;体质量指数（BMI）（19.8±5.4） kg/m2,显著低于生存组（23.2±5.6） kg/m2（t值分别为5.180、7.373,P均＜0.01）,但两组性别差异无统计学意义（P＞0.05）;死亡组与生存组病例1 s用力呼气容积（FEV1）、FEV1/用力肺活量（FEV1/FVC）、英国医学研究委员会呼吸困难量表（MMRC）评级分别为（1.1±0.4）L、（40.8±8.2）％、（2.8±1.3）级与（1.5±0.5）L、（46.3±11.2）％、（2.1±1.2）级,FEV1、FEV1/FVC均显著低于生存组,MMRC评级显著高于生存组,差异均有统计学意义（t值分别为9.582、5.914、6.797,P均＜0.01）;死亡组病例C反应蛋白（CRP）、白细胞介素（IL）6、IL-8、肿瘤坏死因子（TNF）α、中性粒细胞分别为（4.8±1.2） mg/L、（154.4±28.6） ng/L、（398.8±86.3）ng/L、（942.6±212.8）ng/L、（6.0±2.8）×109/L,显著高于生存组（3.4±1.1） mg/L、（112.8 ±23.6） ng/L、（332.7±76.3）ng/L、（1 482.8 ±223.6）ng/L、（5.1±1.5）×109/L,差异均有统计学意义（t值分别为14.818、20.242、10.041、29.684、6.299,P均＜0.01）.结论 包括CRP、IL-6、IL-8、TNF-α和中性粒细胞在内的炎性生物标志物是COPD患者死亡的危险因素,临床应重视对患者炎性生物标志物水平的监测,指导临床筛查高危病例,及时采取相应处理手段,改善预后.Objective To investigate the clinical significance of related inflammatory biomarkers on chronic obstructive pulmonary disease （COPD） associated mortality,in order to provide the basis for clinical screening of high risk patients.Methods One thousand five hundred cases of outpatients and inpatients from Feb.2012 to Mar.2013 were selected as our subjects.All patients were conducted 15-27 months followup.According to patient outcome,they were divided into survival（1346 cases） and death groups （154 cases）.The clinical data,pulmonary function,level of respiratory difficulty and inflammatory biomarker levels were recorded.Results The average age of the death group was （65.3 ± 12.2） years old,significantly higher than that of the survival group （（60.2 ± 11.5） years old,and the difference was significant （t =5.180,P 〈 0.01）.Body mass index（BMI） in death group was （19.8 ±5.4） kg/m2,significantly lower than that of the survival group（23.2 ± 5.6） kg/m2 and the difference was significant （t =7.373,P 〈 0.01）.There was no statistical difference between the two groups in terms of gender （P 〉 0.05）.The levels of 1 s forced expiratory volume （FEV1）,FEV1/forced vital capacity （FVC）,the British Medical Research Council dyspnea scale （MMRC） rating in death group were （1.1 ± 0.4） L,（40.8 ± 8.2） % and （2.8 ± 1.3）,significantly lower than those of the survival group（（1.5 ±0.5） L,（46.3 ± 11.2） %,（2.1 ± 1.2））..FEV1 and FEV1/FVC of death group were significantly lower than those of the survival group,while the MMRC significantly higher,and the differences were significant （t =9.582,5.914,6.797,P 〈 0.01）.The levels of C-reactive protein（CRP）,interleukin-6（IL-6）,IL-8,tumor necrosis factor-α （TNF-α）,neutrophil levels in death group were （4.8 ± 1.2）mg/L,（154.4 ± 28.6） ng/L,（398.8 ± 86.3） ng/L,（942.6 ± 212.8） ng/L,（6.0 ± 2.8） × 109/L,significantly higher than those of the survival group （（3.4

关 键 词：炎性生物标志物 慢性阻塞性肺疾病 危险因素 

分 类 号：R563.9[医药卫生—呼吸系统]