血清IMA水平对COPD病情的评估  

Assessment of disease severity by serum IMA levels in patients with COPD

作　　者：侯玉磊[1] 毕小云[1] 陈特[1] 邓小玲[1] 张莉萍[1] 

机构地区：[1]重庆医科大学附属第一医院检验科,重庆400016

出　　处：《重庆医学》2017年第19期2642-2643,2648,共3页Chongqing medicine

摘　　要：目的探讨血清缺血修饰清蛋白(IMA)在慢性阻塞性肺疾病(COPD)病情评估中的价值。方法选取2015年9月至2016年3月在该院诊治的COPD患者81例纳入COPD组(急性加重期50例,稳定期31例),同时收集30例非COPD的志愿者作为对照组;测定两组血清IMA水平并进行比较,分析COPD患者血清IMA水平与血清肌红蛋白(MYO)、肌钙蛋白T(TNT)、C反应蛋白(CRP)水平及全血白细胞(WBC)计数的相关性,绘制受试者工作特征(ROC)曲线,分析血清IMA水平在COPD的诊断价值。结果 COPD组血清IMA水平明显高于对照组[84.1(79.1,88.5)U/Lvs.73.1(70.2,75.1)U/L],急性加重期COPD患者血清IMA水平明显高于稳定期患者[85.5(82.3,89.4)U/L vs.78.1(75.9,83.0)U/L],急性加重期和稳定期COPD患者血清IMA水平均明显高于对照组,差异均有统计学意义(P<0.05)。COPD患者血清IMA水平与血清MYO水平呈明显正相关(r=0.554,P=0.00);ROC曲线表明,当取截断值为76.55U/mL时,IMA诊断COPD的灵敏度为88.5%,特异度为80.0%,ROC曲线下面积为0.88。结论血清IMA水平在COPD病情评估方面有较好的临床价值,值得扩大样本进一步研究。Objective To explore the value of serum ischemia modified albumin （IMA） level in assessment of disease severity for patients with chronic obstructive pulmonary disease （COPD）. Methods A total of 81 cases of patients with COPD treated in our hospital from September 2015 to March 2016 were selected （COPD group） ,including 51 cases of patients with acute exacerba- tion of COPD and 30 cases of patients with stable of COPD. Meanwhile, 30 volunteers without COPD were collected as control group. Serum levels of IMA were detected and compared among different groups. Correlations between serum level of IMA and ser- um level of myoglobin （MYO） ,troponin T （TNT） and C reactive protein （CRP） ,and white blood cell （WBC） count were analyzed respectively. A receiver operating characteristic （ROC） curve was also plotted to investigate the diagnostic value of serum IMA level for diagnosing COPD. Results Serum level of IMA in the COPD group was higher than that in the control group [84.1 （79.1, 88.5） U/L vs. 73.1 （70.2,75.1） U/L], serum level of IMA in patients with acute exacerbation of COPD was higher than that of pa- tients with stable of COPD [85.5 （82.3,89.4）U/L vs. 78.1 （75.9,83.0）U/L] ,serum levels of IMA in patients with acute exacer bation and stable of COPD both were higher than that in the control group, there were statistically significant differences （P〈0.05）. The serum level of IMA was positively related with serum level of MYO in patients with COPD （r=0. 554 ,P=0.00）. ROC curve indicated when the cutoff value was set as 76.55 U/L, the sensitivity and specificity of serum level of IMA for diagnosing COPD was 88.5% and 80.0% respectively,and area under the ROC curve was 0.88. Conclusion Serum level of IMA could be a valuable indicator for clinically assessing disease severity of patients with COPD,which deserves further study through expanding samples size.

关 键 词：肺疾病 慢性阻塞性 缺血修饰清蛋白 诊断 

分 类 号：R563.9[医药卫生—呼吸系统]