血清胰石蛋白在慢性阻塞性肺疾病中的表达及临床意义

发布时间：2018-05-30 19:27

本文选题：慢性阻塞性肺疾病 + 胰石蛋白　；参考：《遵义医学院》2017年硕士论文

【摘要】：目的:观察血清胰石蛋白(PSP/Reg)在COPD急性期、缓解期及健康体检者中的表达情况,探讨血清胰石蛋白在慢性阻塞性肺疾病急性加重期患者诊疗中的临床意义。方法:选取75名急性期COPD患者作为A组,将A组按病情由轻到重分为轻(A1组)、中(A2组)、重(A3组)三组。将A组经治疗后症状缓解者作为R组,将R组由轻到重分为R1、R2、R3三组。26名健康体检者作为对照组(H组),将A组中痰培养阳性者作为S组,将S组中症状缓解后痰培养转阴者作为S1组。收集研究对象年龄、性别、CAT评分,收集A、R、H组空腹静脉血,测定血清PSP/Reg浓度。测定A组入院当天的降钙素原(PCT)、C-反应蛋白(CRP)、白介素-6(IL-6)、红细胞沉降率(ESR)、白细胞计数(WBC)、中性粒细胞计数(N)及痰培养,痰培养阳性者达到临床明显缓解后再次行痰培养检查。待病情平稳后测定肺功能。观察A组、S组中PSP/Reg与PCT、CRP、IL-6、ESR、WBC、N的相关性。结果:急性期的A组血清PSP/Reg水平显著高于症状缓解后的R组,差异有统计学意义(P0.05);急性期的A组及缓解后的R组血清PSP/Reg水平显著高于健康对照H组,差异有统计学意义(P0.05);急性期血清PSP/Reg水平在A1、A2、A3各组间差异显著(P0.05),且呈递增趋势;A2、A3、S组经治疗后,血清PSP/Reg水平下降明显,差异有统计学意义(P0.05);急性期血清PSP/Reg水平与CRP正相关(P0.05),与其他指标无相关性(P0.05)。痰培养阳性组血清PSP/Reg水平与CRP呈正相关(P0.05)。结论:血清PSP/Reg有可能可作为评估肺部炎性感染的指标,与PCT、CRP等炎性指标联合使用有更好的诊断价值;血清PSP/Reg有可能可作为AECOPD病情评估的有效指标之一,与肺功能、临床症状、急性加重情况联合使用更有助于患者病情的评估;血清PSP/Reg水平在治疗前后存在显著差异,可能有助于疾病治疗效果的评估。
[Abstract]:Objective: To observe the clinical significance of serum trypsin (PSP/Reg) in patients with acute COPD, remission and health examination, and to explore the clinical significance of serum trypsin in the diagnosis and treatment of acute exacerbation of chronic obstructive pulmonary disease. Methods: 75 patients with acute COPD were selected as A group, and group A was divided into light (A1) from light to weight (A2). Group A (group A3) three groups. Group A was treated as R group after treatment, and group R from light to heavy to R1, R2, R3 in group.26 name as control group (H group). The sputum culture positive in A group was taken as S group. Fasting venous blood, determination of serum PSP/Reg concentration. Determination of calcitonin (PCT), C- reactive protein (CRP), -6 (IL-6), erythrocyte sedimentation rate (ESR), leukocyte count (WBC), neutrophils count (N) and sputum culture in A group. The sputum culture of sputum culture positive patients after clinical obvious remission. The correlation between PSP/Reg and PCT, CRP, IL-6, ESR, WBC, N in group A and group S was observed. Results: the serum PSP/Reg level in the acute phase of the A group was significantly higher than that of the R group after the symptom remission. The levels of serum PSP/Reg in the acute phase of A1, A2, and A3 were significantly different (P0.05) and increased, and the level of serum PSP/Reg decreased significantly in A2, A3, S group after treatment, the difference was statistically significant (P0.05), and there was no correlation between the serum PSP/Reg level and the other indexes in the acute stage. Positive correlation with CRP (P0.05). Conclusion: serum PSP/Reg may be used as an indicator of pulmonary inflammatory infection and is of better diagnostic value combined with PCT, CRP and other inflammatory markers. Serum PSP/Reg may be one of the effective indicators for the assessment of AECOPD, and is more helpful to the combined use of lung power, clinical symptoms and acute exacerbation. There is a significant difference in serum PSP/Reg level before and after treatment, which may be helpful to evaluate the therapeutic effect of the disease.
【学位授予单位】：遵义医学院
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R563.9

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