血清PTX3在慢性阻塞性肺疾病急性加重期患者中的表达水平及临床意义

发布时间：2018-06-24 18:38

本文选题：慢性阻塞性肺疾病 + 急性加重　；参考：《山东大学》2016年硕士论文

【摘要】：研究背景慢性阻塞性肺疾病(chronic obstructive pulmonary disease,COPD)是一种以持续性、不完全可逆性及进行性气流受限为特征的慢性肺部炎症疾病,在全球范围内具有很高的发病率和死亡率。慢性阻塞性肺疾病急性加重(acute exacerbation of chronic pulmonary obstructive disease, AECOPD)是指一种急性起病过程,患者呼吸系统症状恶化,超出日常的变异范围,并且需要改变现有的药物治疗。目前,AECOPD的诊断主要依据患者的临床表现及药物使用情况,具有较强的主观性,缺乏高效、客观的生物学标记物。正五聚蛋白3 (Pentraxin 3,PTX3),与C-反应蛋白(c-reactive protein, CRP)同属五聚素家族,它作为一种急性期反应蛋白,在多种炎症过程中表达增高,而目前关于PTX3与／ECOPD的关系在国内外缺少相关报道。本研究旨在检测慢阻肺急性加重期患者血清的PTX3表达水平,并研究其与其他炎症标记物、相关临床参数的相关性,从而进一步探讨PTX3在AECOPD患者中的临床价值。方法选取自2015年4月至2015年12月于山东大学第二医院呼吸内科住院的慢性阻塞性肺疾病急性加重期患者48例,同时选取山东大学第二医院查体中心健康体检人员22例作为健康对照组。收集并记录两组研究对象的基本资料包括年龄、性别、吸烟史。AECOPD组患者于入院当天或次日清晨、健康体检者于查体当天抽取肘部空腹静脉血。采用酶联免疫吸附法(enzyme linked immunosorbent assay, ELISA)检测AECOPD组患者和健康对照组血清PTX3水平。慢性阻塞性肺疾病急性加重期患者于入院24小时内完成超敏CRP、降钙素原(procalcitonin, PCT)、白细胞计数(white blood count, WBC),及中性粒细胞百分比(N%)值等指标检测,以及完成慢性阻塞性肺疾病评估测试(COPD Assessment Test, CAT)、动脉血气分析检测。我们也对健康对照组对象进行CRP、PCT、WBC及N%的检测。本实验采用SPSS17.0统计学软件进行数据分析,计量资料采用均数±标准(x±s)差表示,计量资料间比较采用t检验。如果变量符合正态分布,变量之间的相关性采用Person法分析；如果变量不符合正态分布,变量之间的相关性采用Spearman法分析。P0.05则差异具有统计学意义。结果1.AECOPD患者血清PTX3水平高于健康对照组患者,差异有统计学意义(P0.05)。2.相关性分析显示AECOPD患者血清PTX3水平与中性粒细胞百分比、CAT评分、CRP水平呈正相关(P0.05),与PCT水平、白细胞计数、PCO2、PO2无相关性(P0.05)。结论AECOPD患者血清PTX3水平表达增高,可能与慢阻肺急性加重期患者的中性粒细胞比例增加有关,且PTX3可能与AECOPD患者的疾病严重程度相关。
[Abstract]:Background chronic obstructive pulmonary disease (chronic obstructive pulmonary) is a chronic pulmonary inflammatory disease characterized by persistent, incomplete reversible and progressive airflow limitation. Acute exacerbation of chronic obstructive pulmonary disease (acute exacerbation of chronic pulmonary obstructive disease, AECOPD) refers to an acute onset process in which the respiratory system symptoms deteriorate beyond the range of daily variations and require changes in existing medication. At present, the diagnosis of AECOPD is mainly based on the clinical manifestations of patients and drug use, with strong subjectivity, lack of efficient and objective biological markers. Pentraxin 3 (PTX3) belongs to the c-reactive family. As an acute phase reactive protein, it is highly expressed in various inflammatory processes. However, there are few reports on the relationship between PTX3 and / or ECOPD at home and abroad. The aim of this study was to detect the expression of PTX3 in serum of patients with acute exacerbation of chronic obstructive pulmonary disease (COPD) and to study the correlation between PTX3 and other inflammatory markers and related clinical parameters in order to further explore the clinical value of PTX3 in AECOPD patients. Methods from April 2015 to December 2015, 48 patients with acute exacerbation of chronic obstructive pulmonary disease (COPD) were enrolled in Department of Respiratory Medicine, second Hospital of Shandong University. At the same time, 22 health examiners in the physical examination center of the second Hospital of Shandong University were selected as the healthy control group. The basic data of the two groups were collected and recorded, including age, sex, smoking history. The patients in AECOPD group were collected on the day of admission or early in the next day. The serum levels of PTX3 in patients with AECOPD and healthy controls were detected by (enzyme linked immunosorbent assay, Elisa. In patients with acute exacerbation of chronic obstructive pulmonary disease, hypersensitive CRP, procalcitonin (PCT), white blood cell count (white blood count, WBC) and neutrophil percentage (N%) were detected within 24 hours after admission. Assessment test (cat) and arterial blood gas analysis were completed. We also detected the WBC and N% of CRPG PCT in healthy control subjects. In this experiment, SPSS 17.0 statistical software was used to analyze the data. The mean 卤standard (x 卤s) difference was used to measure the data, and t test was used to compare the measured data. If variables conform to normal distribution, the correlation between variables is analyzed by person method; if variables do not conform to normal distribution, the correlation between variables is analyzed by Spearman method. Results 1. The level of serum PTX3 in AECOPD patients was significantly higher than that in healthy controls (P0.05). 2. Correlation analysis showed that the serum PTX3 level in AECOPD patients was positively correlated with the level of neutrophil percentage cat score and CRP (P0.05), but had no correlation with PCT level and white blood cell count (PCO2PO2) (P0.05). Conclusion the increase of serum PTX3 expression in patients with AECOPD may be related to the increase of neutrophil ratio in patients with acute exacerbation of COPD, and PTX3 may be related to the severity of AECOPD.
【学位授予单位】：山东大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R563.9

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