血清可溶性人基质裂解素2和降钙素原水平的变化在AECOPD患者中的病情评估  

Index changes of serumal soluble human stromelysin-2 and procalcitonin assess the patients of AECOPD

作　　者：朱默然[1] 许德凤[2] 赵云峰[3] 刘锦铭[4] 赵蕾[2] 

机构地区：[1]宁夏医科大学,银川750003 [2]上海市浦东新区公利医院呼吸内科,上海200135 [3]上海市浦东新区浦南医院呼吸内科,上海200125 [4]上海市肺科医院肺循环科,上海200433

出　　处：《中华肺部疾病杂志（电子版）》2017年第2期187-191,共5页Chinese Journal of Lung Diseases(Electronic Edition)

基　　金：上海市浦东新区卫生系统重点专科建设项目资助(PWZZ2013-07)

摘　　要：目的探讨血清可溶性人基质裂解素2(sST2)与慢性阻塞性肺疾病急性加重期(AECOPD)患者病情严重程度的关系及临床意义。方法检测120例(Ⅰ级30例、Ⅱ级30例、Ⅲ级30例和Ⅳ级30例)AECOPD患者治疗前后的血清sST2、降钙素原(PCT)、C反应蛋白(CRP)水平,并分析血清sST2、PCT、CRP水平与CAT评分、6 min步行距离(6 minutes walk distance,6MWD)之间的相关性。另选择30例体检正常人员作为对照组。结果 (1)AECOPD组治疗前血清sST2、PCT、CRP水平显著高于治疗后和对照组(P值均<0.05),且在一定程度上随着病情严重程度的增加而增加;(2)COPD严重程度分级与血清sST2、CRP、PCT水平存在相关性(r=0.588,r=0.447,r=0.305,P值均小于0.01),Ⅰ级、Ⅱ级COPD患者血清sST2水平明显低于Ⅲ级、Ⅳ级患者(t=9.600,P<0.01);(3)血清sST2水平与患者CAT量表呈正相关(r=0.363,P<0.01),随着血清sST2水平的升高,CAT量表数值也升高;与6MWD呈负相关(r=-0.434,P<0.01),随着血清sST2水平的升高,6MWD距离下降。结论Ⅲ级、Ⅳ级AECOPD患者血清sST2水平高于Ⅰ级、Ⅱ级AECOPD患者,随病情好转,血清sST2水平降低显著。血清sST2水平可以在一定程度上反映AECOPD患者病情严重程度,对AECOPD患者病情评估具有临床价值。Objective To analyse the severity of disease and the evaluation of serum quality of life value of serumal soluble human stromelysin-2 and procalcitonin in the patients with acute exacerbation of chronic obstructive pulmonary disease （AECOPD）. Methods The serumal soluble human stromelysin-2, procalcitonin, C reactive protein were detected in 120 hospitalized AECOPD patients before and after the treatment, and to study the correlation above indexes with severity of COPD, COPD assessment test（CAT） and 6 minutes walk distance （6MWD）. Results Compared with after the treatment patients and healthy control group, serumal levels of the soluble human stromelysin-2, procalcitoniu, C-reactive protein were significantly elevated in the patient with AECOPD before the treatment （ P 〈 0.05 ）. To some extent, the levels of these indicators were increasing with the increase in the severity of the disease. The severity classification of COPD were positively correlated with serum sST2, C RP and PCT levels （ r = 0.588, r = 0.132, r = 0.305, P〈0.01 ） , serum sST2 level of the combined Class I and I1 COPD patients was significantly lower than the combined Class HI and IV COPD patients （t = 9.600, P〈0.01）. The serumal sST2 was positively correlated with CAT （r=0.363, P〈0.01） , and was negatively correlated with 6MWD （r=-0.434, P〈0.01）. Conclusions The serumal sST2 levels in HI, IV level AECOPD patients were higher than Ⅰ , Ⅱstage AECOPD patients, and with the condition improved, serumal sST2 decreased significantly. Serumal sST2 can reflect the severity of AECOPD patients in some extent, and has certain clinical value to evaluate the condition of AECOPD patients.

关 键 词：急性加重 肺疾病 慢性阻塞性 可溶性人基质裂解素2 降钙素原 C反应蛋白 CAT评分量表 6 MIN步行试验 

分 类 号：R563[医药卫生—呼吸系统]