肺表面活性蛋白-D在慢性阻塞性肺疾病的高分辨率CT分型中的作用  

作　　者：周立红 丁勇敏[1] 陈玲肖[1] 俞哲燕 王洁 孙超敏 应洁 

机构地区：[1]浙江省嵊州市人民医院,312400

出　　处：《浙江临床医学》2023年第2期219-221,共3页Zhejiang Clinical Medical Journal

摘　　要：目的 探讨血清肺表面活性蛋白-D(SP-D)与慢性阻塞性肺疾病(COPD)患者的高分辨率CT(HRCT)不同表型及预后的相关性.方法 123例稳定期COPD患者于1周内完成HRCT与肺功能检查,同时抽取外周血检测血清SP-D含量,完成临床症状评分(内容包括:性别、年龄、体重指数、吸烟史、英国医学研究委员会改良版呼吸问卷)(mMRC)、COPD评估测试(CAT).随访1年内急性发作次数、急诊及住院次数、住院时间等预后指标.结果 根据HRCT表现分型:A型61例,E型42例,M型20例.三组SP-D浓度、CAT、mMRC、急性发作次数、住院次数及时间,差异有统计学意义(P<0.01),肺功能指标FEV1/FVC%、FEV1%、DLCO%等在3种HRCT分型中以M组最低,其次是E组,A组最高,差异有统计学意义(P<0.01).SP-D浓度与HRCT分型(A型、E型及M型)相关(r=0.66,P<0.01).SP-D浓度与各个肺功能指标呈负相关.SP-D与稳定期COPD患者的预后指标均呈正相关,尤其是急性加重次数(r=0.50,P<0.01).结论 SP-D与稳定期COPD患者的HRCT分型相关,并可能是这些患者不良预后的有效评价指标.Objective To investigate the relationship between serum pulmonary surfactant protein-D(SP-D)and different phenotypes and prognosis of chronic obstructive pulmonary disease(COPD)patients on high-resolution CT(HRCT).Methods 123 patients with stable COPD completed HRCT and pulmonary function test within 1 week.At the same time,peripheral blood was drawn to detect serum SP-D content,and clinical symptom scores were completed(contents included:gender,age,body mass index,smoking history,modified British version)Medical Research Council Respiratory Questionnaire(mMRC),COPD Assessment Test(CAT).Prognostic indicators such as the number of acute attacks,the number of emergency rooms and hospitalizations,and the length of hospitalization within 1 year were followed up.Results According to HRCT phenotype,there were 61 cases of type A,42 cases of type E,and 20 cases of type M.Among the three HRCT types,SP-D concentration,CAT,mMRC,the number of acute attacks,and the number of hospitalizations and time were the highest in group M,again in group E,and the lowest in group A,with statistical significance(P<0.01).Among the three HRCT types,the pulmonary function indexes FEVi/FVC%,FEV%,and DLCO%were the lowest in group M,followed by group E,and were the highest in group A,and the difference was significant(P<0.01).The concentration of SP-D was positively correlated with HRCT types(type A,type E and type M),with statistical significance(r=0.66,P<0.01).SP-D concentration was negatively correlated with each lung function index.SP-D was positively correlated with the prognostic indicators of stable COPD patients,particularly,number of acute exacerbations(r=0.50,P<0.01).ConclusionSP-D is associated with HRCT classification in stable COPD patients,and may be an effective indicator for poor prognosis of these patients.

关 键 词：慢性阻塞性肺疾病 肺表面活性蛋白-D 计算机体层成像 肺功能检查 

分 类 号：R56[医药卫生—呼吸系统]