早期急性肺栓塞患者血清中葡萄糖调节蛋白78和葡萄糖调节蛋白94的表达水平及意义  

The level and significance of serum glucose regulated protein 78 and 94 in the early stage of acute pul monary embolism

作　　者：王涛[1] 裴复阳[1] 侯硕[1] 王琪[2] Wang Tao;Pei Fuyang;Hou Shuo;Wang Qi(Department of Respiratory,Affiliated Zhongshan Hospital of Dalian University,Dalian 116001,China;Department of Respiratory,the Second Affiliated Hospital of Dalian Medical University,Dalian 116027,China)

机构地区：[1]大连大学附属中山医院呼吸内科,116001 [2]大连医科大学附属第二医院呼吸科,116027

出　　处：《中国医师进修杂志》2021年第10期893-897,共5页Chinese Journal of Postgraduates of Medicine

摘　　要：目的通过观察早期急性肺栓塞患者血清中葡萄糖调节蛋白(GRP)78和GRP94的水平,探讨其在急性肺栓塞中的表达及意义。方法选择2018年1月至2020年3月大连大学附属中山医院收治的早期急性肺栓塞患者90例为肺栓塞组及40例健康成年人定义为对照组,比较两组患者血清中D-二聚体、GRP78、GRP94的水平,根据2019年欧洲心脏学会的肺栓塞诊治指南将急性肺栓塞组分为高、中、低危组(高危组:存在血流动力学障碍,中危组:右心室功能不全和/或心脏生物学标志物升高,低危组:无上述表现),比较三组患者血清D-二聚体、GRP78、GRP94、血气分析、肺动脉压、肺栓塞风险评分(PESI)的水平。结果两组患者年龄、性别、体质量指数比较差异无统计学意义(P>0.05),但两组患者血清中D-二聚体、GRP78、GRP94水平比较,肺栓塞组高于对照组[(3.86±1.82)mg/L比(0.31±0.15)mg/L、(2.68±0.71)μg/L比(1.64±0.38)μg/L、(1.31±0.29)μg/L比(0.98±0.13)μg/L],差异有统计学意义(P<0.05)。高危组患者血清D-二聚体、GRP78、GRP94的水平及肺动脉压、PESI评分均高于低危组和中危组[(5.63±1.75)mg/L比(2.29±0.51)和(3.64±1.02)mg/L、(3.24±0.76)μg/L比(2.17±0.41)和(2.64±0.47)μg/L、(1.57±0.33)μg/L比(1.12±0.13)和(1.26±0.14)μg/L、(47.75±6.98)mmHg(1 mmHg=0.133 kPa)比(26.15±4.63)和(35.21±5.85)mmHg、(123.5±20.59)分比(85.5±14.31)和(102.5±13.32)分](P<0.05),中危组上述指标均高于低危组(P<0.05),高危组患者PO2水平低于低危组和中危组[(53.85±5.53)mmHg比(76.21±4.96)mmHg和(72.71±4.76)mmHg](P<0.05),中危组低于低危组(P<0.05)。三组患者血气分析pH比较差异无统计学意义(P>0.05),高危组患者血气分析PCO2水平低于中危组和低危组(P<0.05),中危组与低危组比较差异无统计学意义(P>0.05)。肺栓塞组患者血清D-二聚体、GRP78、GRP94与PESI评分均呈正相关,r=0.610、0.622、0.627,P均<0.01。肺栓塞组治疗后D-二聚体、GRP7Objective To investigate the significance and level of serum GRP78 and GRP94 in the early stage ofacute pulmonary embolism.Methods Ninety APE patients(APE group)and forty healthy controls(control group)in Affiliated Zhongshan Hospital of Dalian University from January 2018 to March 2020 were recruited.The level of serum D-Dimer,GRP78 and GRP94 were compared between the two groups.The pulmonary embolism group was divided into three groups according to guidelines for the diagnosis and treatment of pulmonary embolism in ESC in 2019:low risk,medium risk,high risk,The level of serum D-Dimer,GRP78,GRP94,blood gas,pulmonary arterial pressure,PESI mark of three groups were compared.Results Two groups had no significant difference in sex,age,body mass index(P>0.05),but the level of serum D-Dimer,GRP78 and GRP94 in control group and APE group were higher than those in the control group:(3.86±1.82)mg/L vs.(0.31±0.15)mg/L,(2.68±0.71)μg/L vs.(1.64±0.38)μg/L,(1.31±0.29)μg/L vs.(0.98±0.13)μg/L(P<0.05).The levels of serum D-Dimer,GRP78,GRP94,pulmonary arterial pressure,PO2,PESI score of different degree group(low risk,medium risk,high risk)were higher than those of low risk group and medium risk group:(5.63±1.75)mg/L vs.(2.29±0.51)and(3.64±1.02)mg/L,(3.24±0.76)μg/L vs.(2.17±0.41)μg/L and(2.64±0.47)μg/L,(1.57±0.33)μg/L vs.(1.12±0.13)and(1.26±0.14)μg/L,(47.75±6.98)mmHg(1 mmHg=0.133 kPa)vs.(26.15±4.63)and(35.21±5.85)mmHg,(123.5±20.59)scores vs.(85.5±14.31)and(102.5±13.32)scores(P<0.05),and that of medium risk group were higher than those of low risk group(P<0.05).But PO2 of high risk group was lower than that of low risk group and medium risk group(P<0.05),and PO2 of medium risk group was lower than that of low risk group(P<0.05).pH of three group had no significant difference(P>0.05).PCO2 of high risk group was lower than that of low risk group and medium risk group(P<0.05),and PCO2 of medium risk group and low risk group had no significant difference(P>0.05).The level of serum D-Dimer,GRP78,GRP94 wer

关 键 词：肺栓塞 血清 葡萄糖调节蛋白78 葡萄糖调节蛋白94 

分 类 号：R563.5[医药卫生—呼吸系统]