COPD急性加重期血清Ferr、CEA和D-二聚体水平变化及意义  

Changes and significance of serum Ferr,CEA and D-dimer levels in patients with acute exacerbation of COPD

作　　者：金旭[1] 包先丽 张春芳[1] 樊启光[1] 李博[1] JIN Xu;BAO Xian-li;ZHANG Chun-fang;FAN Qi-guang;LI Bo(Department of Emergency,Hepingli Hospital,Beijing 100013,China)

机构地区：[1]北京市和平里医院急诊科,北京100013

出　　处：《川北医学院学报》2021年第3期340-343,共4页Journal of North Sichuan Medical College

基　　金：北京市东城区科技计划项目(S20190707001)。

摘　　要：目的:探讨慢性阻塞性肺疾病(COPD)急性加重期患者血清铁蛋白(Ferr)、癌胚抗原(CEA)和D-二聚体(D-D)水平变化及意义。方法:210例COPD患者根据病情将急性加重期患者设为观察组(n=100),稳定期患者设为对照组(n=110)。比较两组患者入院第1天、第3天、第7天及第14天血清Ferr、CEA和D-D水平,分别比较不同病情(入院7 d内)和不同预后(出院时)COPD急性加重期患者血清Ferr、CEA和D-D水平,分析出院时Ferr、CEA、D-D水平对COPD急性加重期患者预后的预测价值。结果:观察组入院第1天、第3天、第7天血清Ferr、CEA、D-D水平均高于对照组(P<0.05),两组第14天血清Ferr、CEA、D-D水平比较,差异无统计学意义(P>0.05);GOLD分级4级的COPD急性加重期患者入院7 d内Ferr、CEA、D-D水平高于GOLD分级3级者(P<0.05);COPD急性加重期患者28 d内死亡者血清Ferr、CEA、D-D水平高于存活者(P<0.05)。ROC曲线分析发现,出院时血清Ferr、CEA、D-D水平联合预测COPD急性加重期患者28 d死亡的曲线下面积(0.869)均高于单项预测值。结论:血清Ferr、CEA和D-D水平随COPD病情加重而升高,出院时Ferr、CEA和D-D水平对COPD预后有一定预测价值。Objective:To analyze the changes and significance of serum ferritin(Ferr),carcinoembryonic antigen(CEA)and D-dimer(D-D)levels in patients with acute exacerbation of chronic obstructive pulmonary disease(COPD).Methods:A total of 210 patients with COPD were selected as the subjects.Among them,there were 100 patients in the acute exacerbation period(observation group)and 110 patients in stable phase(control group).The serum levels of Ferr,CEA and D-D were compared between the two groups on the 1,3,7 and 14 d after admission.The levels of serum Ferr,CEA and D-D in patients with acute exacerbation of COPD in different conditions(within 7 days after admission)and different prognosis(at discharge)were compared.The predictive value of Ferr,CEA and D-D levels for the prognosis of patients with acute exacerbation of COPD at discharge was analyzed.Results:The levels of serum Ferr,CEA and D-D in the observation group on the 1,3 and 7 d after admission were higher than those in the control group(P<0.05).There was no significant difference in the level of serum Ferr,CEA or D-D between the two groups on the 14 d after admission(P>0.05).The average levels of Ferr,CEA and DD in patients with GOLD grade 4 acute exacerbation of COPD within 7 days after admission were higher than those with GOLD grade 3(P<0.05).The levels of serum Ferr,CEA and D-D in patients who died within 28 days of acute exacerbation of COPD were higher than those in survivors(P<0.05).ROC curve analysis showed that the area under the curve oflevels of serum Ferr,CEA and D-D at discharge for predicting 28-day death of patients with acute exacerbation of COPD was 0.869,which was larger than that of serum Ferr,CEA and DD(0.828,0.702,0.845).Conclusion:The levels of serum Ferr,CEA and DD increasewith the severity of the disease,and the levels atdischarge are of certain predictive value for prognosis.

关 键 词：慢性阻塞性肺疾病 急性加重期 稳定期 血清铁蛋白 癌胚抗原 D-二聚体 

分 类 号：R563.9[医药卫生—呼吸系统]