血清淀粉样蛋白A水平在慢性阻塞性肺疾病急性加重期的变化及其意义  

Changes of Serum Amyloid A Level and Its Significance in Acute Exacerbation of Chronic Obstructive Pulmonary Disease

作　　者：陆徐峰[1] 周海英[1] 胡志雄[1] 

机构地区：[1]复旦大学附属金山医院呼吸科,上海201508

出　　处：《中国临床医学》2015年第5期613-615,共3页Chinese Journal of Clinical Medicine

摘　　要：目的:探讨血清淀粉样蛋白A(serum amyloid A,SAA)水平在慢性阻塞性肺疾病急性加重期(acute exacerbation of chronic obstructive pulmonary disease,AECOPD)患者中的变化及其临床意义。方法:选择2012年6月—2013年12月收治的AECOPD患者140例和同期就诊的COPD缓解期患者80例及健康对照者40例,检测血清中SAA、C反应蛋白(CRP)、肿瘤坏死因子-α(TNF-α)及白细胞介素-8(IL-8)水平。结果 :与健康体检者比较,COPD患者的血清SAA、TNF-α、IL-8、CRP水平均显著升高(P<0.05),AECOPD组的血清SAA、TNF-α、IL-8、CRP水平显著高于COPD缓解组(P<0.05);血清SAA与TNF-α、IL-8显著相关(r分别为0.78、0.69,P<0.01),CRP与TNF-α、IL-8也具有显著相关性(r分别为0.68、0.62,P<0.01);SAA的ROC曲线下面积(0.841)大于CRP的ROC曲线下面积(0.749),差异具有统计学意义(P<0.05)。结论:血清SAA有望作为一项新的AECOPD的生物标志物,其血清浓度与疾病的严重程度相关;早期检测SAA的变化有助于判断病情的变化,指导疾病的治疗,值得在临床推广。Objective：To explore the changes and clinical significance of serum amyloid A（SAA）level in patients with acute exacerbation of chronic obstructive pulmonary disease（AECOPD）.Methods： A total of 140 patients with AECOPD,80 patients with stable stage COPD and 40 health controls during Jun.2012 and Dec.2013 were collected.The serum levels of SAA,C-reactive protein（CRP）,tumor necrosis factor-α（TNF-α）and interleukin-8（IL-8）were measured.Results：The serum levels of SAA,CRP,TNF-αand IL-8 in all patients with COPD were significantly higher than those in the controls（P〈0.05）.The serum levels of SAA,CRP,TNF-αand IL-8 in patients with AECOPD were significantly higher than those in patients with stable stage COPD（P〈005）.SAA level was significantly correlated with TNF-αlevel and IL-8 level（r=0.78,r=0.69,P〈0.01）.Serum CRP level was also significantly correlated with TNF-αlevel and IL-8 level（r=0.68,r=0.62,P〈0.01）.The area under ROC curve of SAA（0.841）was larger than that of CRP（0.749）,and the difference was statistically significant（P〈0.05）.Conclusions：SAA could be applied as a new biomarker for AECOPD.Its serum level was correlated with the severity of disease.Early detection of SAA may be conducive to the evaluation of disease situation and the treatment strategy for disease.Thus,it is worthy of clinical application.

关 键 词：慢性阻塞性肺疾病 急性加重 血清淀粉样蛋白A 

分 类 号：R563[医药卫生—呼吸系统]