急性加重期慢性阻塞性肺疾病患者治疗前后肺功能及血清DES、MRpro-ADM、Galectin-3变化研究

Changes of pulmonary function and serum DES,MRpro-ADM,and Galectin-3 in patients with acute exacerbation of chronic obstructive pulmonary disease before and after treatment.

目的探讨急性加重期慢性阻塞性肺疾病(AECOPD)患者治疗前后肺功能及血清锁链素(DES)、肾上腺髓质素前体中段肽(MRpro-ADM)、半乳糖凝集素-3(Galectin-3)变化及其临床意义。方法选取西电集团医院急诊科2016年10月至2019年10月收治的AECOPD患者90例作为研究对象,所有患者均予以常规治疗,治疗两周对比治疗前后患者的肺功能指标[第1秒用力呼气容积(FEV1)、用力肺活量(FVC)、第1秒用力呼气容积占用力肺活量百分比(FEV1/FVC)]和血清DES、MRpro-ADM、Galectin-3水平的变化,分析血清各指标与肺功能相关性。并比较不同疗效患者血清DES、MRpro-ADM、Galectin-3水平,评价血清各指标与疗效的关系。结果治疗两周后患者的FEV1、FVC、FEV1/FVC明显高于治疗前,而血清DES、MRpro-ADM、Galectin-3水平明显低于治疗前,差异均有统计学意义(P<0.05);血清DES、MRpro-ADM、Galectin-3水平与FEV1、FVC、FEV1/FVC呈负相关(P<0.05);治疗两周后,显效患者的血清DES、MRpro-ADM、Galectin-3水平明显低于有效和无效患者,差异均有统计学意义(P<0.05);经Logistic回归分析结果显示,血清DES、MRpro-ADM、Galectin-3水平与疗效显著相关(P<0.05)。结论AECOPD患者肺功能改善程度与血清DES、MRpro-ADM、Galectin-3水平关系密切,临床可通过监测上述血清因子水平变化,及时调整治疗方案。

Objective To investigate the changes of pulmonary function and serum desmosine(DES),midregional fragment of pro-adrenomedullin(MRpro-ADM),and galectin-3(Galectin-3)in patients with acute exacerbation of chronic obstructive pulmonary disease(AECOPD)before and after treatment,and to analyze their clinical significance.Methods Ninety patients with AECOPD admitted to Department of Emergency Medicine,Xidian Group Hospital from October 2016 to October 2019 were selected as the research objects.All patients received conventional treatment.After 2 weeks of treatment,the pulmonary function indexes(forced expiratory volume in the first second[FEV1],forced vital capacity[FVC],forced expiratory volume in the first second/force vital capacity[FEV1/FVC]),the changes of serum DES,MRpro-ADM,and Galectin-3 levels before and after treatment were compared,and the correlation between serum indexes and pulmonary function was analyzed.The serum levels of DES,MRpro-ADM,and Galectin-3 in patients with different therapeutic effects were compared,and the relationship between serum indexes and therapeutic effects was evaluated.Results After 2 weeks of treatment,the patients'FEV1,FVC,FEV1/FVC were significantly higher than those before treatment,while serum DES,MRpro-ADM,and Galectin-3 levels were significantly lower than those before treatment,with statistically significant differences(P<0.05).Serum DES,MRpro-ADM,Galectin-3 levels were negatively correlated with FEV1,FVC,FEV1/FVC(P<0.05).After 2 weeks of treatment,the serum DES,MRpro-ADM,and Galectin-3 levels of patients with markedly effective results were significantly lower than those of patients with effective and ineffective results,and the differences were statistically significant(P<0.05).Logistic regression analysis showed that serum DES,MRpro-ADM,Galectin-3 levels were significantly correlated with the efficacy(P<0.05).Conclusion The improvement of pulmonary function in AECOPD patients is closely related to the serum DES,MRpro-ADM,and Galectin-3 levels.Clinically,the treatment plan can be adjusted in time by monitoring the changes of the above-mentioned serum factor levels.