慢性阻塞性肺疾病患者血清NE、α1-AT、CRP、PCT的表达及与肺功能的关系研究
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摘要
目的:探讨慢性阻塞性肺疾病(COPD)患者血清中性粒细胞弹性蛋白酶(NE)、α1-抗胰蛋白酶(α1-AT)、C-反应蛋白(CRP)、降钙素原(PCT)的表达水平及其与肺功能的相关性。方法:选取2013年3月-2015年6月河北北方学院附属第一医院呼吸内科收治的COPD患者87例作为研究对象,其中急性加重期(急性组)患者49例,稳定期(稳定组)患者38例,另选取同时期在本院进行健康体检的志愿者30例为对照组,检测并对比急性组、稳定组和对照组受试者的血清NE、α1-AT、CRP、PCT水平及肺功能指标,并分析COPD患者NE、α1-AT、CRP、PCT水平与肺功能的相关性。结果:与对照组对比,急性组与稳定组患者的NE、CRP、PCT水平均明显升高,α1-AT水平明显降低(P<0.05),且急性组患者的NE、CRP、PCT水平高于稳定组,α1-AT水平低于稳定组(P<0.05);急性组与稳定组患者的第1秒用力呼气容积占预计值的百分比(FEV1%)、第1秒用力呼气容积/用力肺活量(FEV1/FVC)均低于对照组,且急性组FEV1%、FEV1/FVC低于稳定组(P<0.05);经Spearman相关性分析显示,NE、CRP、PCT与FEV1%及FEV1/FVC均呈负相关,α1-AT与FEV1%及FEV1/FVC呈正相关(P<0.05)。结论:COPD患者血清NE、CRP、PCT表达水平均明显升高,α1-AT表达水平明显降低,且NE、α1-AT、CRP、PCT均与肺功能存在一定相关性,加强对此类指标的监测有助于对COPD患者病情判断及治疗指导。
Objective: To investigate the expression of neutral granulocyte elastase(NE), α1-antitrypsin(α1-AT), C-reactive protein(CRP) and procalcitonin(PCT) in patients with chronic obstructive pulmonary disease(COPD) and its correlation with pulmonary function. Methods: A total of 87 COPD patients, who were treated in First Affiliated Hospital of Hebei North University from March2013 to June 2015, were chosen as subjects, among them, 49 cases were acute exacerbation(acute group), 38 cases were stable phase(stable group); another 30 volunteers, who underwent physical examination during the same period, were chosen as control group. The serum levels of NE, α1-AT, CRP, PCT and pulmonary function in the acute group, stable group and control group were detected and compared, the correlation of NE, α1-AT, CRP and PCT levels with pulmonary function in COPD patients was analyzed. Results: Compared with the control group, the levels of NE, CRP and PCT in the acute group and the stable group were significantly increased, and the level of α1-AT was significantly lower(P<0.05); the levels of NE, CRP and PCT in the acute group were higher than those in the stable group, and the level of α1-AT was lower than that in the stable group(P<0.05). Percentage of forced expiratory volume at first second to predicted value(FEV1%) and forced expiratory volume at first second to forced vital capacity(FEV1/FVC) in the acute and the stable group were lower than those in the control group, FEV1%, FEV1/FVC in the acute group was lower than that in the stable group(P<0.05). Spearman correlation analysis showed that NE, CRP and PCT were negatively correlated with FEV1% and FEV1/FVC, and α1-AT was positively correlated with FEV1% and FEV1/FVC(P<0.05). Conclusion: The levels of serum NE, CRP and PCT in the patients with COPD are significantly increased, the expression level of α1-AT is obviously decreased, and NE, α1-AT, CRP and PCT are related to pulmonary function. To strengthen the monitoring of such indicators is helpful for the diagnosis and treatment of COPD patients.
Objective: To investigate the expression of neutral granulocyte elastase(NE), α1-antitrypsin(α1-AT), C-reactive protein(CRP) and procalcitonin(PCT) in patients with chronic obstructive pulmonary disease(COPD) and its correlation with pulmonary function. Methods: A total of 87 COPD patients, who were treated in First Affiliated Hospital of Hebei North University from March2013 to June 2015, were chosen as subjects, among them, 49 cases were acute exacerbation(acute group), 38 cases were stable phase(stable group); another 30 volunteers, who underwent physical examination during the same period, were chosen as control group. The serum levels of NE, α1-AT, CRP, PCT and pulmonary function in the acute group, stable group and control group were detected and compared, the correlation of NE, α1-AT, CRP and PCT levels with pulmonary function in COPD patients was analyzed. Results: Compared with the control group, the levels of NE, CRP and PCT in the acute group and the stable group were significantly increased, and the level of α1-AT was significantly lower(P<0.05); the levels of NE, CRP and PCT in the acute group were higher than those in the stable group, and the level of α1-AT was lower than that in the stable group(P<0.05). Percentage of forced expiratory volume at first second to predicted value(FEV1%) and forced expiratory volume at first second to forced vital capacity(FEV1/FVC) in the acute and the stable group were lower than those in the control group, FEV1%, FEV1/FVC in the acute group was lower than that in the stable group(P<0.05). Spearman correlation analysis showed that NE, CRP and PCT were negatively correlated with FEV1% and FEV1/FVC, and α1-AT was positively correlated with FEV1% and FEV1/FVC(P<0.05). Conclusion: The levels of serum NE, CRP and PCT in the patients with COPD are significantly increased, the expression level of α1-AT is obviously decreased, and NE, α1-AT, CRP and PCT are related to pulmonary function. To strengthen the monitoring of such indicators is helpful for the diagnosis and treatment of COPD patients.
引文
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[22]Tamura K,Takashima H,Fumoto K,et al.Possible Role ofα1-Antitrypsin in Endometriosis-Like Grafts From a Mouse Model of Endometriosis[J].Reprod Sci,2015,22(9):1088-1097
[23]Zhang H,Wang X,Zhang Q,et al.Comparison of procalcitonin and high-sensitivity C-reactive protein for the diagnosis of sepsis and septic shock in the oldest old patients[J].BMC Geriatr,2017,17(1):173
[24]赵明丽,王玉忠,张露露,等.COPD合并肺心病患者血清hs-CRP、BNP的含量及临床意义[J].中国实验诊断学,2016,20(10):1670-1672Zhao Ming-li,Wang Yu-zhong,Zhang Lu-lu,et al.Correlational studies of serum hs-CRP,BNP level and their clinical significance and patients with COPD complicated with pulmonary heart disease[J].Chinese Journal of Laboratory Diagnosis,2016,20(10):1670-1672
[25]Yang JS,Gerber JN,You HJ.Association between fasting insulin and high-sensitivity C reactive protein in Korean adults[J].BMJ Open Sport Exerc Med,2017,3(1):e000236
[26]Mockel M,Searle J,Maisel A.The role of procalcitonin in acute heart failure patients[J].ESC Heart Fail,2017,4(3):203-208
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[28]Machin M,Amaral AF,Wielscher M,et al.Systematic review of lung function and COPD with peripheral blood DNA methylation in population based studies[J].BMC Pulm Med,2017,17(1):54
[29]蔡岩,王大伟,郑伟,等.慢性阻塞性肺疾病急性加重期患者的血清锁链素、C反应蛋白水平及其与肺功能的相关性[J].广西医学,2015,37(11):1620-1623Cai Yan,Wang Da-wei,Zheng Wei,et al.Serum levels of desmosine and C-reactive protein and their correlation with lung function in patients with acute exacerbation of chronic obstructive pulmonary disease[J].Guangxi Medical Journal,2015,37(11):1620-1623
[30]Sterk PJ.Chronic diseases like asthma and COPD:do they truly exist?[J].Eur Respir J,2016,47(2):359-361
[2]elutkien J,Bal iūnas M,Kablu ko D,et al.Challenges of Treating Acute Heart Failure in Patients with Chronic Obstructive Pulmonary Disease[J].Card Fail Rev,2017,3(1):56-61
[3]Hoaas H,Morseth B,Holland AE,et al.Are Physical activity and Benefits Maintained After Long-Term Telerehabilitation in COPD?[J].Int J Telerehabil,2016,8(2):39-48
[4]Tsai LLY,Mc Namara RJ,Dennis SM,et al.Satisfaction and Experience With a Supervised Home-Based Real-Time Videoconferencing Telerehabilitation Exercise Program in People with Chronic Obstructive Pulmonary Disease(COPD)[J].Int J Telerehabil,2016,8(2):27-38
[5]Goldman RE,Mennillo L,Stebbins P,et al.How do patients conceptualize chronic obstructive pulmonary disease?[J].Chron Respir Dis,2017,14(3):245-255
[6]Henneuse A,Suchon P,Chambost H,et al.α1-antitrypsin Pittsburgh and plasmin-mediated proteolysis[J].J Thromb Haemost,2016,14(10):2023-2026
[7]Huang X,Zheng Y,Zhang F,et al.Molecular Mechanism of Zα1-Antitrypsin Deficiency[J].J Biol Chem,2016,291(30):15674-15686
[8]Loke I,stergaard O,Heegaard NHH,et al.Paucimannose-Rich N-glycosylation of Spatiotemporally Regulated Human Neutrophil Elastase Modulates Its Immune Functions[J].Mol Cell Proteomics,2017,16(8):1507-1527
[9]Mohammed J,Da Silva H,Van Oosterwijck J,et al.Effect of respiratory rehabilitation techniques on the autonomic function in patients with chronic obstructive pulmonary disease:A systematic review[J].Chron Respir Dis,2017,14(3):217-230
[10]Verduri A,Luppi F,D'Amico R,et al.Antibiotic treatmnet of severe exacerbations of chronic obstructive pulmonary disease Withprocalcition:a randomized noninferiority trial[J].PLo S One,2015,10(3):e011824
[11]Usuki T,Sugimura T,Komatsu A,et al.Biomimetic Chichibabin pyridine synthesis of the COPD biomarkers and elastin cross-linkers isodesmosine and desmosine[J].Org Lett,2014,16(6):1672-1675
[12]Emami Ardestani M,Zaerin O.Role of Serum Interleukin 6,Albumin and C-Reactive Protein in COPD Patients[J].Tanaffos,2015,14(2):134-140
[13]Picart J,Moiton MP,Gaüzère B A,et al.Introduction of a PCT-based algorithm to guide antibiotic prescription in COPD exacerbation[J].Med Mal Infect,2016,46(8):429-435
[14]Gilbert DN.Role of Procalcitonin in the Management of Infected Patients in the Intensive Care Unit[J].Infect Dis Clin North Am,2017,31(3):435-453
[15]中华医学会呼吸病学分会慢性阻塞性肺疾病学组.慢性阻塞性肺疾病诊治指南(2013年修订版)[J].中华结核和呼吸杂志,2013,36(4):255-264Chronic obstructive pulmonary disease study group of Chinese Medical Association Respiratory Diseases Branch.Guidelines for the diagnosis and treatment of chronic obstructive pulmonary disease(Revised Edition,2013)[J].Chinese Journal of Tuberculosis and Respiratory Diseases,2013,36(4):255-264
[16]Rahimi-Ead MH,Sadighi T,Rabieepour M,et al.Prevalence of anemia and its impact on mortality in patients with acute exacerbation of chronic obst ructive pulmonary disease in a developing country setting[J].Pneumologia,2015,64(3):27-30
[17]Machado Rodrigues F,Demeyer H,Hornikx M,et al.Validity and reliability of strain gauge measurement of volitional quadriceps force in patients with COPD[J].Chron Respir Dis,2017,14(3):289-297
[18]马涛,黄璐,赵阳,等.针灸对肝郁化火型失眠患者NE及PKC,BDNF表达水平的影响[J].现代生物医学进展,2016,16(21):4071-4074Ma Tao,Huang Lu,Zhao Yang,et al.Effects of Acupuncture on NE Content and PKC,BDNF Gene Expression in Patients with Insomnia of Type of Stagnation of Liver Fire[J].Progress in Modern Biomedicine,2016,16(21):4071-4074
[19]Vergelli C,Schepetkin IA,Crocetti L,et al.Isoxazol-5(2H)-one:a new scaffold for potent human neutrophil elastase(HNE)inhibitors[J].J Enzyme Inhib Med Chem,2017,32(1):821-831
[20]Joly P,Restier L,Bouchecareilh M,et al.DEFI-ALPHA cohort and POLYGEN DEFI-ALPHA clinical research hospital programme.A study about clinical,biological and genetics factors associated with the occurrence and the evolution of hepatic complications in children with alpha-1 antitrypsin deficiency[J].Rev Mal Respir,2015,32(7):759-767
[21]O'Meara A,Kapel N,Xhaard A,et al.Fecal calprotectin andα1-antitrypsin dynamics in gastrointestinal Gv HD[J].Bone Marrow Transplant,2015,50(8):1105-1109
[22]Tamura K,Takashima H,Fumoto K,et al.Possible Role ofα1-Antitrypsin in Endometriosis-Like Grafts From a Mouse Model of Endometriosis[J].Reprod Sci,2015,22(9):1088-1097
[23]Zhang H,Wang X,Zhang Q,et al.Comparison of procalcitonin and high-sensitivity C-reactive protein for the diagnosis of sepsis and septic shock in the oldest old patients[J].BMC Geriatr,2017,17(1):173
[24]赵明丽,王玉忠,张露露,等.COPD合并肺心病患者血清hs-CRP、BNP的含量及临床意义[J].中国实验诊断学,2016,20(10):1670-1672Zhao Ming-li,Wang Yu-zhong,Zhang Lu-lu,et al.Correlational studies of serum hs-CRP,BNP level and their clinical significance and patients with COPD complicated with pulmonary heart disease[J].Chinese Journal of Laboratory Diagnosis,2016,20(10):1670-1672
[25]Yang JS,Gerber JN,You HJ.Association between fasting insulin and high-sensitivity C reactive protein in Korean adults[J].BMJ Open Sport Exerc Med,2017,3(1):e000236
[26]Mockel M,Searle J,Maisel A.The role of procalcitonin in acute heart failure patients[J].ESC Heart Fail,2017,4(3):203-208
[27]He C,Wang B,Wang YF,et al.Can procalcitonin be used to diagnose Gram-negative bloodstream infection?Evidence based on a meta-analysis[J].Eur Rev Med Pharmacol Sci,2017,21(14):3253-3261
[28]Machin M,Amaral AF,Wielscher M,et al.Systematic review of lung function and COPD with peripheral blood DNA methylation in population based studies[J].BMC Pulm Med,2017,17(1):54
[29]蔡岩,王大伟,郑伟,等.慢性阻塞性肺疾病急性加重期患者的血清锁链素、C反应蛋白水平及其与肺功能的相关性[J].广西医学,2015,37(11):1620-1623Cai Yan,Wang Da-wei,Zheng Wei,et al.Serum levels of desmosine and C-reactive protein and their correlation with lung function in patients with acute exacerbation of chronic obstructive pulmonary disease[J].Guangxi Medical Journal,2015,37(11):1620-1623
[30]Sterk PJ.Chronic diseases like asthma and COPD:do they truly exist?[J].Eur Respir J,2016,47(2):359-361