血清α1-抗胰蛋白酶和颗粒蛋白前体对慢性阻塞性肺疾病急性加重期的诊断价值  

Diagnostic value of serumα1-antitrypsin and progranulin in acute exacerbation of chronic obstructive pulmonary disease

作　　者：任松涛 赵强[2] 王焕东[2] Ren Songtao;Zhao Qiang;Wang Huandong(Emergency Department,Affiliated Hospital of Huanghuai University(Zhumadian Central Hospital),Zhumadian 463000,China;Emergency Department of Henan Chest Hospital,Zhengzhou 450008,China)

机构地区：[1]黄淮学院附属医院(驻马店市中心医院)急诊科,驻马店463000 [2]河南省胸科医院急诊科,郑州450008

出　　处：《中华实验外科杂志》2024年第11期2609-2612,共4页Chinese Journal of Experimental Surgery

基　　金：2023年度河南省医学科技攻关计划联合共建项目(LHGJ20230114)。

摘　　要：目的:探讨血清α1-抗胰蛋白酶和颗粒蛋白前体对慢性阻塞性肺疾病急性加重期的诊断价值。方法:选取驻马店市中心医院和河南省胸科医院2020年6月至2023年6月收治的慢性阻塞性肺疾病急性加重期103例患者作为观察组,选取同期就诊的103例稳定期慢性阻塞性肺病患者作为对照组。两组患者清晨抽取静脉血,测定对照组和观察组患者血清α1-抗胰蛋白酶和颗粒蛋白前体水平变化。将急性加重期慢性阻塞性肺疾病患者根据简化急性生理学评分Ⅱ分为轻度、中度和重度,比较血清α1-抗胰蛋白酶和颗粒蛋白前体水平变化;根据患者是否发生呼吸衰竭,将患者分为呼吸衰竭组和无呼吸衰竭组,比较血清α1-抗胰蛋白酶和颗粒蛋白前体水平变化。并采用受试者工作曲线分析血清α1-抗胰蛋白酶和颗粒蛋白前体水平与患者呼吸衰竭的关系。组间计量数据采用独立样本 t检验。 结果:对照组患者血清α1-抗胰蛋白酶和颗粒蛋白前体水平[(6.18±1.52) mg/L、(159.90±41.57) μg/L]明显低于观察组患者[(9.86±2.85) mg/L、(200.20±46.26) μg/L],差异有统计学意义( t=11.550,6.251, P<0.05)。轻度慢性阻塞性肺疾病急性加重期患者血清α1-抗胰蛋白酶和颗粒蛋白前体水平[(6.98±0.82) mg/L、(148.51±16.70) μg/L]明显低于中度患者[(9.43±0.78) mg/L、(201.54±19.75) μg/L],差异有统计学意义( t=12.360,11.820, P<0.05)。中度慢性阻塞性肺疾病急性加重期患者血清α1-抗胰蛋白酶和颗粒蛋白前体水平[(9.43±0.78) mg/L、(201.54±19.75) μg/L]明显低于重度患者[(13.01±1.80) mg/L、(249.42±17.76) μg/L],差异有统计学意义( t=10.150,10.440, P<0.05)。无呼吸衰竭慢性阻塞性肺疾病急性加重期患者血清α1-抗胰蛋白酶和颗粒蛋白前体水平[(7.98±1.50) mg/L、(167.68±30.17) μg/L]明显低于呼吸衰竭患者[(12.37±2.23) mg/L、(243.81±21.27) μg/L],差异有统计学意义( t=14.290,11.920, P<0.0Objective To investigate the diagnostic value of serumα1-antitrypsin and progranulin in acute exacerbation of chronic obstructive pulmonary disease.Methods 103 patients with acute exacerbation of chronic obstructive pulmonary disease in Zhumadian central hospital and Henan Provincial chest hospital from June 2020 to June 2023 were selected as the observation group,and 103 patients with stable chronic obstructive pulmonary disease in our hospital were selected as the control group.Venous blood was drawn from the two groups in the morning,and the changes of serumα1-antitrypsin and progranulin levels in the control group and the observation group were measured.The patients with acute exacerbation of chronic obstructive pulmonary disease were divided into mild,moderate and severe according to the Simplified Acute Physiology ScoreⅡ.The changes of serumα1-antitrypsin and progranulin levels were compared;According to whether the patients developed respiratory failure,the patients were divided into respiratory failure group and no respiratory failure group,and the changes of serumα1-antitrypsin and progranulin levels were compared.The relationship between serumα1-antitrypsin and progranulin levels and respiratory failure was analyzed by receiver operating curve.Independent sample t-test was used for inter group measurement data.ResultsThe serum levels ofα1-antitrypsin and progranulin in the control group[(6.18±1.52)mg/L,(159.90±41.57)μg/L]were significantly lower than those in the observation group[(9.86±2.85)mg/L,(200.20±46.26)μg/L,t=11.550,6.251,P<0.05].The serum levels ofα1-antitrypsin and progranulin in patients with mild chronic obstructive pulmonary disease at acute exacerbation stage[(6.98±0.82)mg/L,(148.51±16.70)μg/L]were significantly lower than those in moderate patients[(9.43±0.78)mg/L,(201.54±19.75)μg/L,t=12.360,11.820,P<0.05].The serum levels ofα1-antitrypsin and progranulin in patients with acute exacerbation of moderate chronic obstructive pulmonary disease[(9.43±0.78)mg/L,(201.54±1

关 键 词：血清α1-抗胰蛋白酶 颗粒蛋白前体 慢性阻塞性肺疾病急性加重期 

分 类 号：R563.9[医药卫生—呼吸系统]