血清淀粉样蛋白A在慢性阻塞性肺疾病急性加重期中的应用价值  

Value of serum amyloid A in patients with acute exacerbation of chronic pulmonary diseases

作　　者：黎艳聪[1] 张杰斯 郭超文[1] 袁健志 李付艺 LI Yancong;ZHANG Jiesi;GUO Chaowen;YUAN Jianzhi;LI Fuyi(Department of Respiration,Affiliated Xiaolan Hospital Southern Medical University,Zhongshan 528415,China)

机构地区：[1]南方医科大学附属小榄医院呼吸内科,广东省中山市528415

出　　处：《实用医学杂志》2017年第14期2349-2352,共4页The Journal of Practical Medicine

摘　　要：目的探讨血清淀粉样蛋白A(SAA)在慢性阻塞性肺疾病急性加重期(AECOPD)中的应用价值。方法随机入选符合入选标准的AECOPD患者70例,根据痰细菌培养是否阳性将AECOPD患者分为2组:感染组和加重组。慢性阻塞性肺疾病稳定期(SCOPD)患者35例设为对照组,收集入选者的一般资料,并完成肺功能、胸片、血常规、血清C反应蛋白(CRP)、SAA、血清白介素-6(IL-6)、血清降钙素原(PCT)检测,比较3组间SAA及相关指标的差异,分析SAA判别有无合并细菌感染的判别效率。结果 SAA在2组AECOPD患者中的水平均显著高于健康对照组,并且感染组显著高于加重组;SAA判别有无合并细菌感染的ROC曲线下面积为0.868 2,当SAA取界值72.10 mg/L时,灵敏度为94.29%,特异度为65.71%。结论 SAA在AECOPD患者中显著升高,在合并细菌感染时升高更显著,是AECOPD非特异性炎症及判别有无合并细菌感染的有效生物标志物之一。Objective To assess the value of serum amyloid A(SAA)in patients with acute exacerbation of chronic pulmonary diseases.Methods Seventy AECOPD patients were randomly chosen.The AECOPD patients were divided into bacterial infection induced group and non?bacterial infection induced group by sputum bacteria culture.Thirty five SCOPD patients were chosen as control group.General data was collected.Lung function,chest X ray,blood routine,CRP,SAA,IL6and PCT were deteced and compared in the3groups.The diagnostic value of SAA to distinguish bacterial infection induced AECOPD was estimated.Results SAA of both AECOPD subgroups were significantly higher than that of healthy controls.SAA in infection group is higher that that in exacerbation group.In terms of ROC curve,AUC was0.8682for SAA to distinguish merging bacterial infection,and the cutoff value was72.10mg/L with sensitivity of94.29%and specificity of65.71%.Conclusion SAA increases in AECOPD patients,and more obviously in AECOPD patients with bacterial infection.SAA may be used as a reliable biomarker not only to distinguish AECOPD patients from SCOPD patients,but also distinguish merging bacterial infection during AECOPD.

关 键 词：慢性阻塞性肺疾病 慢性阻塞性肺疾病急性加重 血清淀粉样蛋白A 细菌感染 

分 类 号：R563.9[医药卫生—呼吸系统]