摘要
目的探讨慢性阻塞性肺疾病(COPD)急性加重期患者血清胱抑素C(Cys-C)水平变化的临床意义。方法 COPD患者120例分为急性加重期(发作组)和疾病稳定期(稳定组)两组,每组60例。检测并比较两组患者的用力肺活量(FVC)、第一秒用力呼气容积(FEV1)、一秒率(FEV1/FVC)、最大呼气中期流量(MMEF)、白细胞计数、中性粒细胞分数、肾小球滤过率(GFR)以及CRP、BUN、SCr、血清Cys-C的水平。根据血清Cys-C水平将发作组分为Cys-C正常组(18例)和Cys-C增高组(42例)。比较Cys-C正常组和增高组上述指标,分析Cys-C与各指标的相关性。结果发作组FEV1、FVC、FEV1/FVC、MMEF低于稳定组(P<0.05),白细胞计数、中性粒细胞分数、CRP、SCr、血清Cys-C水平高于稳定组(P<0.05)。Cys-C增高组FEV1、FVC、FEV1/FVC、MMEF、GFR低于Cys-C正常组(P<0.05),白细胞计数、中性粒细胞分数、CRP、SCr水平高于Cys-C正常组(P<0.05)。Cys-C与FVC、FEV1、FEV1/FVC、MMEF呈负相关(r=-0.638、-0.524、-0.455、-0.421,P=0.009、0.014、0.026、0.034),与CRP、SCr呈正相关(r=0.673、0.196,P=0.005、0.017)。结论 COPD急性加重期患者血清Cys-C水平升高,治疗过程中监测血清Cys-C水平的变化能更好地评估病情、疗效和预后。
Objective To study the clinical significance of the change of serum cystatin C(Cys-C) level in the patients with acute exacerbation of chronic obstructive pulmonary disease(COPD).Methods A total of 120 COPD patients was assigned into two groups of A(in the acute exacerbation) and C(in the stable stage) with 60 cases each.The levels of forced vital capacity(FVC),forced expiratory volume in 1 second(FEV1),FEV1/FVC,maximal midexpiratory flow(MMEF),WBC count,neutrophil fraction,glomerular filtration rate(GFR),CRP,BUN,SCr and serum Cys-C were detected and compared between two groups.The patients in group A were further divided into two groups of A1(with normal serum Cys-C level,18 cases) and A2(with increased serum Cys-C level,42 cases).The above indicators were compared between groups of A1 and A2 and the correlation between Cys-C and other indicators was analyzed.Results The FEV1,FVC,FEV1/FVC and MMEF were lower,while the levels of WBC count,neutrophil fraction,CRP,SCr and serum Cys-C were higher in group A than those in group C(P<0.05).The FEV1,FVC,FEV1/FVC,MMEF and GFR were lower,while the levels of WBC count,neutrophil fraction,CRP and SCr were higher in group A2 than those in group A1(P<0.05).Cys-C was negatively correlated with FVC,FEV1,FEV1/FVC and MMEF(r=-0.638,-0.524,-0.455 and-0.421,P=0.009,0.014,0.026 and 0.034) and positively correlated with CRP and SCr(r=0.673 and 0.196,P=0.005 and 0.017).Conclusion Serum Cys-C level in acute exacerbation of COPD patients is increased.Monitoring the change of serum Cys-C level during treatment can better evaluate the illness status,therapeutic effect and prognosis of acute exacerbation of COPD patients.
作者
钱利华
QIAN Lihua(Department of Respiratory Diseases, Nanjing Pukou District Central Hospital,Nanjing 2W800, CHINA)
出处
《江苏医药》
CAS
2019年第8期824-826,共3页
Jiangsu Medical Journal
关键词
慢性阻塞性肺疾病急性加重期
胱抑素C
Acute exacerbation of chronic obstructive pulmonary disease
Cystatin C
