重度COPD稳定期患者血清CC16、SP-D、MSP与患者肺功能、病情严重程度的关系
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摘要
目的探讨重度慢性阻塞性肺疾病(COPD)稳定期患者血清人Clara细胞分泌蛋白(CC16)、肺表面活性物质相关蛋白D(SP-D)、血清巨噬细胞刺激蛋白(MSP)水平变化与肺功能、病情严重程度的关系。方法选取2017年1月至2017年9月我院确诊的120例重度COPD稳定期患者(COPD组)、60例年龄及性别相匹配的健康体检对象(对照组),检测并对比两组的血清CC16、SP-D、MSP、第一秒用力呼气容积(FEV_1)、用力肺活量(FVC)、圣乔治呼吸问卷(SGRQ)、6min步行距离。结果 COPD组的血清SP-D、MSP均显著高于对照组,差异具有统计学意义(P <0. 05); COPD组的血清CC16显著的低于对照组,差异具有统计学意义(P <0. 05); COPD组患者的FEV_1、FVC、6MWD显著的低于对照组,差异具有统计学意义(P <0. 05); COPD组的SGRQ评分显著的高于对照组,差异具有统计学意义(P <0. 05);稳定期的COPD组患者血清CC16水平与FEV_1、FVC、6MWD呈显著的正相关关系(P <0. 05),与SGRQ评分呈显著的负相关关系(P <0. 05);稳定期的COPD组患者血清SP-D、MSP与FEV_1、FVC、6MWD呈显著的负相关关系(P <0. 05),与SGRQ评分呈显著的正相关关系(P <0. 05)。结论重度COPD稳定期患者血清CC16水平降低,血清SP-D、MSP升高,并且与患者病情程度、肺功能恶化具有一定的关系。
Objective To investigate the relationship of serum CC16,SP-D and serum MSP levels in patients with severe COPD with lung function and severity. Methods It selected 120 patients with severe COPD at stable stage( the COPD group) and 60 age and gender-matched healthy subjects( the control group) from January 2017 to September 2017. Serum CC16,SP-D,MSP,first-second forced expiratory volume( FVE_1),forced vital capacity( FVC),St. George's Respiratory Questionnaire( SGRQ),and 6-min walking distance were measured and compared between the two groups. Results Serum SP-D and plasma MSP in the COPD group were significantly higher than those in the control group( P < 0. 05). Serum CC16 in the COPD group was significantly lower than that in the control group( P < 0. 05). The levels of FVE_1,FVC and 6 MWD in the COPD group were significantly lower than those in the control group( P < 0. 05). The SGRQ score in the COPD group was significantly higher than that in the control group( P < 0. 05). There was a significantly positive correlation between serum CC16 level and FVE_1,FVC and 6 MWD in patients with stable COPD( P < 0. 05),and a significantly negative correlation with SGRQ score( P <0. 05). For patients with stable COPD,there was a significantly negative correlation between serum SP-D and plasma MSP and FVE_1,FVC and 6 MWD( P < 0. 05),and a significantly positive correlation with SGRQ score( P < 0. 05).Conclusion Serum CC16 level decreases in patients with severe COPD and serum SP-D and MSP increase,and it is related to the degree of disease and deterioration of lung function.
Objective To investigate the relationship of serum CC16,SP-D and serum MSP levels in patients with severe COPD with lung function and severity. Methods It selected 120 patients with severe COPD at stable stage( the COPD group) and 60 age and gender-matched healthy subjects( the control group) from January 2017 to September 2017. Serum CC16,SP-D,MSP,first-second forced expiratory volume( FVE_1),forced vital capacity( FVC),St. George's Respiratory Questionnaire( SGRQ),and 6-min walking distance were measured and compared between the two groups. Results Serum SP-D and plasma MSP in the COPD group were significantly higher than those in the control group( P < 0. 05). Serum CC16 in the COPD group was significantly lower than that in the control group( P < 0. 05). The levels of FVE_1,FVC and 6 MWD in the COPD group were significantly lower than those in the control group( P < 0. 05). The SGRQ score in the COPD group was significantly higher than that in the control group( P < 0. 05). There was a significantly positive correlation between serum CC16 level and FVE_1,FVC and 6 MWD in patients with stable COPD( P < 0. 05),and a significantly negative correlation with SGRQ score( P <0. 05). For patients with stable COPD,there was a significantly negative correlation between serum SP-D and plasma MSP and FVE_1,FVC and 6 MWD( P < 0. 05),and a significantly positive correlation with SGRQ score( P < 0. 05).Conclusion Serum CC16 level decreases in patients with severe COPD and serum SP-D and MSP increase,and it is related to the degree of disease and deterioration of lung function.
引文
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[11]孔香晶,曹丽华.联合检测血清SP-D、hs-CRP及血浆Fbg水平在慢性阻塞性肺疾病患者病情监测中的价值[J].大连医科大学学报,2015,37(5):476-479.
[12]张文波,陈小菊,冷长燕,等.巨噬细胞刺激蛋白在慢性阻塞性肺疾病患者中的表达及意义[J].中国呼吸与危重监护杂志,2016,15(2):115-118.
[13]戴飘飘,刘婷,柳明坤,等.慢性阻塞性肺疾病相关血清生物学标志物[J].中国组织化学与细胞化学杂志,2016,25(5):463-466.
[14]高炎超,梁志华,马展成.稳定期慢性阻塞性肺疾病治疗后炎症介质反应及临床病情的研究[J].中国临床研究,2015,28(3):298-300.
[15]邵红霞,李莉,吴琦,等.不同时期慢性阻塞性肺疾病患者血清SP-D水平变化与ADO指数关系[J].山西医科大学学报,2017,48(6):575-577.
[2] TURNER R M,DEPIETRO M,DING B. Overlap of asthma and chronic obstructive pulmonary disease in patients in the United States:analysis of prevalence,features,and subtypes[J]. JMIR Public Health Surveill,2018,4(3):e60-e63.
[3]陈忠仁,秦篙. SP-D、CCL18、CC16在慢性阻塞性肺疾病急性加重期血清和呼气冷凝液中的变化及临床价值[J].重庆医学,2015,44(19):2638-2640,2643.
[4]郭海燕,林淑芳,梁彩霞,等.血清SP-D、PARC/CCL18水平与慢性阻塞性肺疾病严重程度关系[J].实用医学杂志,2016,32(6):936-938.
[5]杨阳,刘行仁.巨噬细胞刺激蛋白表达水平与慢性阻塞性肺疾病患者肺功能的关系[J].广东医学,2017,38(3):397-401.
[6]路明,姚婉贞.慢性阻塞性肺疾病防治全球倡议(2015年更新版)解读[J].中华医学杂志,2015,95(22):1715-1718.
[7] SCHREIBER A,CEMMI F,AMBROSINO N,et al. Prevalence and Predictors of Obstructive Sleep Apnea in Patients with Chronic Obstructive Pulmonary Disease Undergoing Inpatient Pulmonary Rehabilitation[J]. COPD,2018,15(3):265-270.
[8] MEJZA F,NASTAEK P,DONIEC Z,et al. Symptoms of chronic bronchitis in individuals without chronic obstructive pulmonary disease:prevalence,burden,and risk factors in southern Poland[J].Pol Arch Intern Med,2018,128(11):677-684.
[9] SHAH N M,MURPHY P B. Chronic obstructive pulmonary disease and sleep:an update on relevance,prevalence and management[J]. Curr Opin Pulm Med,2018,24(6):561-568.
[10]王秋波.慢性阻塞性肺疾病患者血清中Clara细胞分泌蛋白CC16和SP-D浓度与肺功能的相关性[J].中国老年学杂志,2016,36(12):2980-2981.
[11]孔香晶,曹丽华.联合检测血清SP-D、hs-CRP及血浆Fbg水平在慢性阻塞性肺疾病患者病情监测中的价值[J].大连医科大学学报,2015,37(5):476-479.
[12]张文波,陈小菊,冷长燕,等.巨噬细胞刺激蛋白在慢性阻塞性肺疾病患者中的表达及意义[J].中国呼吸与危重监护杂志,2016,15(2):115-118.
[13]戴飘飘,刘婷,柳明坤,等.慢性阻塞性肺疾病相关血清生物学标志物[J].中国组织化学与细胞化学杂志,2016,25(5):463-466.
[14]高炎超,梁志华,马展成.稳定期慢性阻塞性肺疾病治疗后炎症介质反应及临床病情的研究[J].中国临床研究,2015,28(3):298-300.
[15]邵红霞,李莉,吴琦,等.不同时期慢性阻塞性肺疾病患者血清SP-D水平变化与ADO指数关系[J].山西医科大学学报,2017,48(6):575-577.