急性肺损伤患者血清中中性粒细胞弹性蛋白酶活性的变化

Changes of serum neutrophil elastase activity in patients with acute lung injury

目的检测急性肺损伤(ALI)患者血清中中性粒细胞弹性蛋白酶(NE)的活性,探讨其临床意义。方法选择符合ALI患者22例,健康对照组15例。计算动脉血氧分压(PaO2)与吸入气氧浓度(FiO2)比值,测定NE活性、α1抗胰蛋白酶α1AT)浓度和活性、白介素6(IL6)和白介素8(IL8)浓度等。结果ALI患者的NE活性、IL6和IL8均明显高于健康对照组,而α1AT活性较健康组降低(P<0.05)。ALI患者中死亡组(10例)的NE活性明显高于存活组(12例)(P<0.01)。而且ALI患者的血清NE活性与PaO2FiO2呈显著负相关(r=-0.874,P<0.01)。结论ALI患者的NE活性明显升高,α1AT活性显著降低,出现蛋白酶抗蛋白酶失衡,而且血清NE活性水平与患者的肺损伤严重程度和预后密切相关。

Objective To study the change of serum neutrophil elastase (NE) activity in patients with acute lung injury (ALI). Method Twenty-two ALI patients and 15 healthy volunteers (control group) were recruited. The arterial blood gas was recorded to calculate PaO_2/FiO_2 ratio in ALI group. The activity of NE, the concentration and activity of α_1-antitrypsin (α_1-AT), the serum concentration of interleukin-6 (IL-6) and interleukin-8 (IL-8) were measured. Results In ALI group, the activity of serum NE and the concentration of IL-6 and IL-8 were significantly higher than those of control group (P<0.01). The activity of α_1-AT in ALI group was significantly lower than that in control group (P<0.05). The activity of serum NE in non-survious (n=10) was significantly higher than that of survival group (n=12, P<0.01). Moreover, the activity of serum NE in ALI patients was inversely related to their PaO_2/FiO_2 ratio (r=-0.874, P<0.01). Conclusion In ALI patients, the activity of serum NE was significantly elevated, but the activity of α_1-AT was reduced. There was an imbalance between protease and antiprotease. The activity of serum NE was significantly related to the severity and prognosis of ALI patients.