慢性阻塞性肺疾病急性加重期患者治疗前后肺功能、SIRS评分及血清炎症因子水平变化与预后的相关性研究  

Changes of lung function,systemic inflammatory response syndrome score and serum inflammatory factors in patients with acute exacerbation of chronic obstructive pulmonary disease before and after treatment and their correlation with the prognosis

作　　者：何国庆[1] 秦勤[1] 罗兰[1] HE Guoqing;Q;LUO Lan(Department of Respiratory Medicine,West China Hospital,Chengdu 610041,China)

机构地区：[1]四川大学华西医院呼吸内科,610041

出　　处：《心肺血管病杂志》2018年第8期757-760,共4页Journal of Cardiovascular and Pulmonary Diseases

摘　　要：目的:探究慢性阻塞性肺疾病急性加重期(AECOPD)患者治疗前后肺功能、全身性炎症反应综合征(SIRS)评分、血清炎症因子水平变化及其预后的相关性。方法:通过肺功能检测仪检测109例AECOPD患者治疗前后肺功能指标[第1秒用力呼气容量占用力肺活量比值(FEV1/FVC)、FEV1占预计值百分比(FEV1%)],酶联免疫吸附法(ELISA)测定血清炎症因子[白介素-6(IL-6)、白介素-8(IL-8)、肿瘤坏死因子-α(TNF-α)、降钙素原(PCT]指标。对AECOPD患者治疗前后行SIRS评分,并分析上述指标与患者预后的相关性。结果:患者治疗后FEV1/FVC、FEV1%较治疗前均显著上升,IL-6、IL-8、TNF-α、PCT水平、SIRS评分显著下降,差异有统计学意义(P<0.05);AECOPD存活组患者入院时FEV1/FVC、FEV1%水平均显著高于死亡组,血清IL-6、IL-8、TNF-α、PCT水平、SIRS评分均显著低于死亡组,差异有统计学意义(P<0.05);FEV1/FVC、FEV1%与患者预后正相关(P<0.05),IL-8、TNF-α、SIRS评分与预后负相关(P<0.05)。结论:肺功能、血清炎症因子、SIRS评分对AECOPD诊断、疗效判断有重要意义,肺功能下降、IL-8、TNF-α水平上升、SIRS评分高为患者死亡的危险因素。Objective： To explore the changes of lung function,systemic inflammatory response syndrome（ SIRS） score and serum inflammatory factors in patients with acute exacerbation of chronic obstructive pulmonary disease（ AECOPD） before and after treatment and their correlation with the prognosis. Methods：The lung function indexes [forced expiratory volume in 1 second/forced vital capacity（ FEV1/FVC）,percentage of FEV1 in predicted value（ FEV1%） ] in 109 patients with AECOPD were detectedbefore and after treatment. Serum inflammatory factors [interleukin-6（ IL-6）,interleukin-8（ IL-8）,tumor necrosis factor-α（ TNF-α）,procalcitonin（ PCT） were determined by enzyme-linked immunosorbent assay（ ELISA） The SIRS scoring of patients with AECOPD was performed before and after treatment,and the correlation between the above indexes and the prognosis was analyzed. Results： After treatment,the FEV1/FVC and FEV1% were significantly increased,levels of IL-6,IL-8,TNF-α and PCT and SIRS scores were significantly decreased（ P〈0.05） The FEV1/FVC and FEV1% in AECOPD survival group were significantly higher than those in the death group on admission. The serum levels of IL-6,IL-8,TNF-α and PCT and SIRS score were significantly lower than those in the death group（ P〈0.05） The FEV1/FVC and FEV1% were positively correlated with the prognosis of patients（ P〈0.05） IL-8,TNF-α and SIRS score were negatively correlated with the prognosis（ P〈0.05） Conclusion： The lung function,serum inflammatory factors and SIRS score are important for diagnosis of AECOPD and assessment of curative effect. The lung function decline,increased IL-8 and TNF-α levels and high SIRS score are risk factors of death.

关 键 词：慢性阻塞性肺疾病急性加重期 肺功能 全身性炎症反应综合征评分 炎症因子 预后 

分 类 号：R56[医药卫生—呼吸系统]