中性粒细胞明胶酶相关脂笼蛋白与慢性阻塞性肺疾病关系的初步研究

发布时间：2018-06-14 19:34

本文选题：慢性阻塞性肺疾病 + NGAL　；参考：《南昌大学》2012年硕士论文

【摘要】：目的：为了探讨血浆NGAL（中性粒细胞明胶酶相关脂笼蛋白）和COPD（慢性阻塞性肺疾病）的关系，通过检测COPD患者、哮喘患者及正常受试者血浆中NGAL水平，研究NGAL与COPD特征的关系，为COPD的临床诊断与鉴别诊断提供依据。方法：选取COPD患者急性加重期和稳定期各25人，取其肘静脉血，同时选取20例哮喘患者及20例正常人取肘静脉血作对照研究，采用ELISA方法检测血浆中NGAL的含量。收集整理COPD患者（急性加重期和稳定期）、哮喘患者及正常人的临床资料及实验室数据如性别、年龄、吸烟与否、肺功能、血白细胞、中性粒细胞。分析比较COPD急性加重期组、稳定期组、哮喘组及正常对照组NGAL水平及吸烟的影响，并将NGAL与吸烟、肺功能、血白细胞、中性粒细胞进行相关性分析。结果：（1）COPD患者（急性加重期组和稳定期组）血浆NGAL水平明显高于正常对照组及哮喘组，差别有统计学意义（P＜0.01），哮喘组与正常对照组NGAL水平无统计学差异(P0.05)。（2）COPD患者血浆中NGAL水平急性加重期组高于稳定期组，，差别有统计学意义（P＜0.05）。（3）COPD重度、极重度患者血浆NGAL水平与COPD轻、中度患者相比，差别无统计学意义(P0.05) （4）血浆NGAL水平与COPD患者血浆中性粒细胞呈正相关，差别有统计学意义(P＜0.05)。（5）正常对照者中，吸烟者血浆NGAL水平与非吸烟者相比升高，差异有统计学意义(P0.01)；吸烟COPD患者NGAL水平与非吸烟吸烟COPD患者相比，差别无统计学意义(P0.05) 结论： 1、COPD患者急性加重期和稳定期血浆中NGAL水平明显升高，且COPD急性加重期组患血浆中NGAL水平高于稳定期组，并且NGAL水平与COPD患者血浆中性粒细胞百分比呈正相关，提示NGAL与COPD发病机制有关，因此NGAL有可能成为COPD一种生物学标记物。 2、哮喘组血浆NGAL水平明显低于COPD患者，与正常对照组相比血浆NGAL水平无差别，因此NGAL有可能成为COPD与哮喘鉴别诊断的标记物。 3、正常对照组中吸烟者血浆NGAL水平、中性粒细胞百分比均高于非吸烟者，FEVl/FVC、 FEVl占预计值百分比均低于非吸烟者，提示吸烟与COPD的发生有关。
[Abstract]:Objective: to investigate the relationship between plasma NGALs (neutrophil gelatinase-associated lipid-cage protein) and cad (chronic obstructive pulmonary disease), and to detect the levels of NGAL in plasma of COPD patients, asthma patients and normal subjects. To study the relationship between NGAL and the characteristics of COPD, to provide basis for clinical diagnosis and differential diagnosis of COPD. Methods: 25 patients with COPD in acute exacerbation and 25 patients in stable stage were selected to take blood from cubital vein, 20 asthmatic patients and 20 normal subjects were selected as control group. The plasma NGAL levels were detected by Elisa. Clinical data and laboratory data such as sex, age, smoking, pulmonary function, white blood cells, neutrophils were collected from patients with COPD (acute exacerbation and stable stage, asthma and normal subjects). The levels of NGAL and smoking in acute exacerbation group, stable stage group, asthma group and normal control group were analyzed and the correlation between NGAL and smoking, lung function, blood leukocyte and neutrophils was analyzed. Results: plasma NGAL levels in COPD patients (acute exacerbation group and stable group) were significantly higher than those in normal control group and asthma group. The difference was statistically significant (P < 0.01). There was no significant difference in NGAL level between asthma group and normal control group (P < 0.05). The plasma NGAL level in patients with COPD in acute exacerbation stage was higher than that in stable stage group, and the difference was significant (P < 0.05). There was no significant difference in plasma NGAL levels between mild and moderate COPD patients (P 0.05) 4) there was a positive correlation between plasma NGAL levels and plasma neutrophils in COPD patients. The difference was statistically significant (P < 0.05) in normal controls, the plasma NGAL level of smokers was higher than that of non-smokers (P < 0.01), and the NGAL level of COPD patients was higher than that of non-smoking COPD patients. Conclusion: 1 the levels of NGAL in plasma of COPD patients in acute exacerbation and stable phase were significantly higher than those in stable COPD patients, and the levels of NGAL in plasma in patients with acute exacerbation of COPD were higher than those in stable COPD. The level of NGAL was positively correlated with the percentage of plasma neutrophils in patients with COPD, suggesting that NGAL might be a biological marker of COPD, and the level of plasma NGAL in asthma group was significantly lower than that in patients with COPD. There was no difference in plasma NGAL levels compared with normal controls, so NGAL might be a marker for differential diagnosis of COPD and asthma. The percentage of neutrophils was higher than that of FEVl / FVCand the percentage of FEVl to predicted value was lower than that of non-smokers, suggesting that smoking was related to the occurrence of COPD.
【学位授予单位】：南昌大学
【学位级别】：硕士
【学位授予年份】：2012
【分类号】：R563.9

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