慢性阻塞性肺疾病患者血清SP—A水平及临床意义的探讨  

Serum SP-A levels in patients with chronic obstructive pulmonary disease and their clinical significance

作　　者：韩丽萍[1] 朱君[1] 贾建军[1] 付甜[1] 苗健龙[1] 

机构地区：[1]山东省济宁市第一人民医院呼吸内科,272000

出　　处：《国际呼吸杂志》2015年第9期663-666,共4页International Journal of Respiration

摘　　要：目的检测COPD稳定期患者血清肺表面活性蛋白A（surfactant proteinA，SP—A）水平，探讨其影响因素及其临床意义。方法选择中、重度COPD稳定期患者54例，健康对照组20例。入选后测量患者身高，体质量；记录吸烟年包、病程；测6分钟步行距离；记录气促分级并评分；填写圣乔治呼吸问卷；用酶联免疫吸附测定法同步检测54例中、重度COPD稳定期患者和20例健康对照者血清SP—A水平，用直线相关分析方法分析了血清SP—A水平与吸烟、病程、肺功能、生活质量、呼吸困难情况、运动耐力、营养状况等的关系。结果COPD患者血清SP-A水平（39．25±6．14）pmol／L显著高于健康对照组血清SP-A水平（15．85±1．81）pmol／L（P〈0．01），其中COPD吸烟组血清SP-A[（49．7±7．05）pmol／L]水平显著高于COPD非吸烟组血清SP—AE（16．52±2．25）pmol／L]水平（P〈0．05）。相关分析表明，COPD患者血清SP—A水平与气流受限指标FEV。呈负相关（r=-0．273，P〈0．05），与生活质量症状评分呈正相关（r=0．363，P〈0．05），与生活质量总评分亦呈正相关（r=0．3，P〈0．05）。结论COPD稳定期患者血清SP-A水平升高，吸烟者升高更为明显，提示血清SP—A参与了COPD的发生、发展，吸烟可能是血清SP—A水平升高的一个因素。血清SP—A水平与气流受限程度和生活质量有关，气流受限越重，生活质量越差，血清SP—A水平越高。Objective To investigate surfactant proteins A （SP A） levels and explore their influencing factors and clinical significance in patients with stable chronic obstructive pulmonary disease （COPD）. Methods A total of 54 stable COPD patients and 20 healthy controls were enrolled. All patients were measured body height and weight, recorded smoking pack-years and measured six-minutes walking test,assessed the degree of dyspnea and St. George Respiratory Questionnaire （SGRQ）. The serum SP-A levels in 54 stable COPD patients and 20 healthy controls were measured by enzyme-linked immunosorbent assay and linear correlation analysis were used to the correlation between serum SP-A and pulmonary function, life quality, dyspnea, exercise capacity, and nutritional status. Results The serum SP-A levels in COPD patients （39.25± 6.14） pmol/L were significantly higher than those in the healthy controls （15.85±1.81） pmol/L（ P〈0.01）. The serum SP-A （49.7±7.05） pmol/L levels in smoking COPD patients were significantly higher than those in the nonsmoking controls （16.52 ± 2.25） pmol/L （P 〈0.05）. Linear correlation analysis showed that the serum SP-A was correlated negtively with forced expiratory volume in one second （ r = -0. 273, P 〈0.05） ,and positively with sympodrom scores of life quality （r =0.363, P 〈0.05）,and positively with total scores of SGRQ（r = 0.3, P 〈0.05）. Conclusions The serum SP-A levels in stable COPD patients were higher. The serum SP-A levels in smoking stable COPD patients were higher than nonsmoking controls. It shows that they take part in the airway inflammation. Smoking maybe a reason of higher serum SP-A levels. The serum SP-A levels in stable COPD patients correlate with airflow limitation, and life quality. The serious is airflow limitation, the worst is life quality and the higher is serum SP-A levels.

关 键 词：慢性阻塞性肺疾病 肺表面活性蛋白A 

分 类 号：R563.9[医药卫生—呼吸系统]