血清淀粉样物质A在慢性阻塞性肺疾病急性加重中的临床意义

The clinical value of serum amyloid A in acute exacerbations of chronic obstructive pulmonary disease

目的探讨血清淀粉样物质A（SAA）在诊断慢性阻塞性肺疾病急性加重（AECOPD）中的临床意义。方法收集2007年6月至2008年12月AECOPD患者86例，慢性阻塞性肺疾病（COPD）缓解期患者46例。采用ELISA法测定sAA，对AECOPD与COPD缓解期患者进行比较，并比较AECOPD患者治疗前后SAA、WBC、中性粒细胞计数、C反应蛋白（CRP）的变化。结果AECOPD患者SAA水平较COPD缓解期患者明显升高[分别为（182．33±50．12）、（6．24±3．05）ms／L，P〈0．05]。AECOPD患者随着抗生素治疗的起效，SAA、CRP逐渐下降，WBC、中性粒细胞计数也有下降趋势。SAA对诊断AECOPD患者肺功能严重程度较CRP敏感。结论SAA对AECOPD的诊断及评价其肺功能严重性具有重要的临床意义。

Objective To investigate the diagnostic value of serum amyloid A（SAA） in diagnosing acute exacerbations of chronic obstructive pulmonary disease （AECOPD）. Methods A total of 86 patients with AECOPD and 46 patients with stable COPD were recruited. SAA determined with ELISA was compared between AECOPD patients and stable COPD patients. The changes of SAA, WBC, the percentage of neutrophils and C-reactive protein （CRP） of AECOPD patients was compared before and immediately after the last treatment procedure. Results The SAA levels in AECOPD patients were higher than those in stable COPD patients [（ 182.33 ± 50.12） mg/L vs （6.24 ± 3.05）mg/L, P 〈 0.05]. The change of SAA was more evident than that of serum WBC and the pereentage of neutrophils before and after the treatment procedure. SAA was more sensitive than CRP in diagnosing lung function severity of AECOPD patients. Conclusion SAA has great diagnostic value in AECOPD diagnosis and evaluation of lung function severity.