慢性阻塞性肺疾病不同分期继发肺部感染的临床特征及血清因子表达水平与肺功能的相关性分析  

Clinical characteristics of different stages and secondary pulmonary infection of chronic obstructive pulmonary disease and the correlation between serum factor expression and pulmonary function

作　　者：曹霖霖 王鹏[1] 张琪[1] 席修明[1] 朱波[1] CAO Linlin;WANG Peng;ZHANG Qi;XI Xiuming;ZHU Bo(Department of Critical Care Medicine,Fu Xing Hospital,Captital Medical University,Beijing,100038,China)

机构地区：[1]首都医科大学附属复兴医院重症医学科,北京100038

出　　处：《临床急诊杂志》2021年第12期802-807,共6页Journal of Clinical Emergency

摘　　要：目的:探讨慢性阻塞性肺疾病(COPD)不同分期继发肺部感染患者的临床特征和前梯度蛋白2(AGR2)、激活T细胞核因子5(NFAT5)、炎症因子表达水平与肺功能的相关性。方法:选取2016年9月—2019年7月于我院治疗的113例COPD患者为研究对象,以58例COPD稳定期患者为稳定期组,55例COPD急性加重期入院患者为急性加重期组;另选取同期于我院健康体检者50例为对照组。分析COPD不同分期继发肺部感染患者的临床特征,检测所有受试者血清中AGR2、NFAT5、炎症因子水平,并分析这些因子与FEV1/FVC的关系。结果:①58例稳定期组患者中有50例继发肺部感染,而55例急性加重期患者入院后有50例继发肺部感染。②COPD患者血清中AGR2、NFAT5和炎性因子(CRP、IL-6、IL-2、TNF-α)水平均高于对照组受试者水平,差异有统计学意义(P<0.05);而急性加重期患者这6个因子的水平又均高于稳定期患者,差异有统计学意义(P<0.05)。③Pearson相关性分析结果显示AGR2、NFAT5与血清CRP、IL-6、IL-2、TNF-α具有显著正相关性(P<0.05)。④确诊继发肺部感染患者的血清中AGR2和NFAT5水平明显高于未继发肺部感染患者水平。⑤COPD患者血清中AGR2、NFAT5和炎性因子(CRP、IL-6、IL-2、TNF-α)水平均与FEV1/FVC呈负相关(P<0.01)。结论:COPD患者血清中AGR2、NFAT5和炎性因子表达水平与肺功能密切相关,且继发肺部感染时伴有AGR2和NFAT5水平明显升高,AGR2和NFAT5可能和炎性因子一样在COPD患者的肺功能和病情变化中发挥重要作用,对COPD的病情预测与评估有一定临床意义。Objective:To investigate the clinical features and correlations of secondary pulmonary infections in different stages of chronic obstructive pulmonary disease and the correlation between the expression of AGR2,NFAT5,inflammatory factor and prognosis.Methods:113patients with COPD treated in our hospital from September 2016to July 2019were selected as the research object.58patients in the stable stage of COPD were in the stable stage of COPD group and 55patients hospitalized in the acute stage of COPD were in the acute stage of COPD group.Another 50cases of physical examination in our hospital in the same period were selected as the control group.The clinical characteristics of pulmonary infection secondary to chronic obstructive pulmonary disease were analyzed;The levels of AGR2,NFAT5and inflammatory factors in serum were detected,and the relationship between these factors and FEV1/FVC was analyzed.Results:There were 50cases of secondary pulmonary infection in 58patients in the stable period group,and 50cases of secondary pulmonary infection after 55patients in acute exacerbation stage were admitted.The levels of serum AGR2,NFAT5and inflammatory factors(CRP,IL-6,IL-2and TNF)in patients with chronic obstructive pulmonary disease were significantly higher than those in the control group(P<0.05),while the levels of these six factors in patients with acute exacerbation were significantly higher than those in patients with stable phase(P<0.05).Pearson correlation analysis showed that AGR2and NFAT5were correlated with serum CRP,1l-6,1l-2and TNF-αThere was a significant positive correlation(P<0.05).ELISA results showed that the serum levels of AGR2and NFAT5in patients with secondary pulmonary infection were significantly higher than those in patients without secondary pulmonary infection.The levels of serum AGR2,NFAT5and inflammatory factors(CRP,IL-6,IL-2and TNF)in patients with chronic obstructive pulmonary disease were negatively correlated with FEV1/FVC(P<0.01).Conclusion:The expression levels of AGR2,NFAT5and inflam

关 键 词：慢性阻塞性肺疾病 前梯度蛋白2 激活T细胞核因子5 炎性因子 相关性 

分 类 号：R563.9[医药卫生—呼吸系统]