慢性阻塞性肺疾病患者C反应蛋白水平及其与肺功能变化的相关性

C-reactive protein level and the correlation between lung function and CRP levels in patients with chronic obstructive pulmonary diseases

目的:探讨在慢性阻塞性肺疾病(COPD)慢性炎症状态下,患者血、晨痰C反应蛋白(CRP)浓度的变化以及肺功能损害程度与CRP浓度变化的关系.方法:选择COPD患者30例,进行肺功能第1秒用力呼气容量(FEV1)和一秒率(FEV1/FVC)测定;收集患者晨痰及同期静脉血,采用ELISA法检测CRP浓度.同时,选择10例健康者作为对照组进行CRP测定.结果:COPD患者血清CRP水平较正常者增高30～50倍,同时,COPD患者晨痰CRP浓度高于同期血中CRP(P<0.05), 患者血CRP与晨痰CRP浓度的变化呈正相关(r=0.625, P<0.05).COPD患者肺功能FEV1变化与血、晨痰CRP浓度变化呈负相关(分别为r=-0.610和r=-0.725, 均P<0.001); 患者肺功能FEV1/FVC变化与血、晨痰CRP浓度变化呈负相关(分别为r=-0.639,和r=-0.600, 均P<0.05).结论:呼吸道局部可能存在CRP的分泌;CRP浓度的增高可能与肺功能损害程度有关.

Objective To investigate the changes of C-reactive protein （CRP） level in patients with chronic obstructive pulmonary diseases （COPD） and to analyze the correlation between the lung function and CRP levels. Methods Sputum and serum specimens were obtained from 30 COPD patients diagnosed according to the national criteria. The CRP level was measured by enzyme-linked immunosorbent assays. The lung function indexes such as the forced expiratory volume in one second （FEV1） and the forced expiratory volume in one second/forced vital capacity （FEV1/FVC） were also determined. Results The sputum CRP level in COPD patients was 30-50 times higher than that of the health controls. The sputum CRP level in COPD patients is significantly higher than that of serum in these patients （P〈0.05）. The correlation between changes of serum and sputum CRP levels and sputum CRP levels was positive （r=0. 625, P〈0.05）. The correlations between changes of serum CRP levels and FEV1 were negative （ r=-0. 610, -0.725, respectively, P 〈0.001）. And the correlations between changes of serum and sputum CRP levels and FEV1/FVC were negative （r=-0. 639, -0.600, respectively, P〈0.05）. Conclusion The CRP may be secreted from the local respiratory tract. The damage of lung function in COPD patients is associated with the increase of CRP level.