白介素—6、降钙素原、D—二聚体与慢阻肺急性加重期患者病情及预后相关性研究
发布时间:2018-04-24 23:16
本文选题:慢性阻塞性肺疾病 + IL-6 ; 参考:《河北医科大学》2016年硕士论文
【摘要】:目的:探讨白介素-6、降钙素原、D-二聚体与慢阻肺急性加重期患者病情及预后相关性研究。方法:2014-11-01至2016--02-01于我院呼吸内科因慢阻肺急性加重期、呼吸衰竭和肺性脑病入住呼吸重症监护室病例(简称重症慢阻肺),所有患者均需气管插管、有创通气,共27例,其中男19例,女8例,平均年龄(72.96±8.89);因慢阻肺急性加重入住普通病房病例(简称普通慢阻肺),以上患者均无需有创通气,共44例,其中男31例,女13例,平均年龄(68.20±11.09);及于我院体检中心体检的健康对照组12例,其中男8例,女4例,平均年龄(66.09±9.14),均签署知情同意书。所有志愿者入院时均抽取患者外周静脉血,应用免疫比浊法检测志愿者血清D-二聚体水平,采用电化学发光法检测检测志愿者血清IL-6水平,发光免疫法检测志愿者降钙素原水平。应用SPSS13.0统计软件收集及分析数据。对重症慢阻肺组、普通慢阻肺及健康对照组三组数据行正态性检验,三组数据均符合正态分布,用均数±标准差((?)±s)描述,行方差齐性检验,方差齐,多样本均数比较行完全随机设计单因素方差分析,此后用SNK法进行两两比较,P0.05为差异具有统计学意义。在重症慢阻肺患者中,死亡组与非死亡组之间比较,两组数据均经正态性检验,符合正态性,方差齐,用均数±标准差(x±s)描述,采用独立样本t检验,P0.05为差异具有统计学意义。结果:重症慢阻肺患者血清IL-6水平(11.60±3.01)均高于普通慢阻肺患者(7.82±2.15)及健康对照组(4.63±1.78),三者间比较有统计学意义(F=39.16,P0.01)。重症慢阻肺患者血清降钙素原水平(0.46±0.08)均高于普通慢阻肺患者(0.12±0.06)及健康对照组(0.07±0.04),三者间比较有统计学意义(F=279.88,P0.01)。重症慢阻肺患者血清D-二聚体水平(2.94±0.72)均高于普通慢阻肺患者(1.45±0.84)及健康对照组(0.86±0.53),三者间比较有统计学意义(F=43.51,P0.01)。在重症慢阻肺患者中,死亡组血清IL-6水平(14.11±2.67)明显高于非死亡组(10.35±2.36),两组间比较有统计学意义(t=3.74,P0.01),死亡组血清降钙素原水平(0.44±0.07)明显高于非死亡组(0.52±0.08),两组间比较有统计学意义(t=2.61,P0.05),死亡组(3.41±0.42)血清D-二聚体水平明显高于非死亡组(2.71±0.74),两组间比较有统计学意义(t=2.96,P0.01)。结论:入院时血清IL-6、降钙素原、D-二聚体水平均与慢阻肺急性加重期患者病情严重程度及预后相关。
[Abstract]:Objective: to investigate the relationship between interleukin-6, procalcitonin D-dimer and patients with acute exacerbation of chronic obstructive pulmonary disease (COPD). Methods from 2014-11-01 to 2016-02-01, 27 patients with respiratory failure and pulmonary encephalopathy were admitted to the Respiratory intensive Care Unit (RICU) in the Department of Respiratory Medicine of our hospital for acute exacerbation of COPD. All the patients need tracheal intubation and invasive ventilation, including 19 males. There were 8 females (mean age 72.96 卤8.89g), 44 patients (31 males, 13 females) who were admitted to the general ward for acute exacerbation of COPD. The average age was 68.20 卤11.09, and 12 healthy controls were examined in the physical examination center of our hospital, including 8 males and 4 females, with an average age of 66.09 卤9.14, all of whom signed informed consent. The peripheral venous blood was extracted from all the volunteers at admission. The serum levels of D-dimer and IL-6 were detected by immunoturbidimetry and electrochemiluminescence respectively. The level of procalcitonin in volunteers was detected by luminescent immunoassay. Collect and analyze data with SPSS13.0 software. The data of severe chronic obstructive lung group, common chronic obstructive lung group and healthy control group were tested for normality. The data of the three groups were all in accordance with normal distribution, described by mean 卤standard deviation) 卤s), and tested by homogeneity test of variance and homogeneity of variance. The analysis of variance of single factor of complete random design was carried out to compare the mean of multiple samples, and then the difference was statistically significant by using SNK method to compare pairwise and pairwise. In the patients with severe chronic obstructive pulmonary disease, the data of the two groups were compared between the death group and the non-death group. The data of the two groups were tested by normality, the variance was the same, and the mean 卤standard deviation (x 卤s) was used to describe the data. The difference was statistically significant by using independent sample t test (P0.05). Results: the level of serum IL-6 in patients with severe COPD was 11.60 卤3.01) higher than that in patients with COPD (7.82 卤2.15) and healthy controls (4.63 卤1.78). The serum procalcitonin level in patients with severe COPD was 0.46 卤0.08) higher than that in normal COPD patients (0.12 卤0.06) and healthy controls (0.07 卤0.04). The serum levels of D-dimer in patients with severe COPD were 2.94 卤0.72) higher than those in patients with COPD (1.45 卤0.84) and healthy controls (0.86 卤0.53). In patients with severe COPD, The serum IL-6 level in the death group (14.11 卤2.67) was significantly higher than that in the non-death group (10.35 卤2.36). There was statistical significance between the two groups, and the serum procalcitonin level in the death group was 0.44 卤0.07, which was significantly higher than that in the non-dead group (0.52 卤0.08). There was significant difference between the two groups. The level of dimer was significantly higher than that of non-death group (2.71 卤0.74), and the difference between the two groups was statistically significant. Conclusion: the levels of serum IL-6 and procalcitonin D-dimer on admission were correlated with the severity and prognosis of patients with acute exacerbation of COPD.
【学位授予单位】:河北医科大学
【学位级别】:硕士
【学位授予年份】:2016
【分类号】:R563.9
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