支气管哮喘急性发作期患者血浆合肽素测定的临床意义

Clinical Significance of Detecting Plasma Copeptin in Patients with Acute Onset of Bronchial Asthma

目的探讨支气管哮喘急性发作期患者血浆合肽素测定的临床意义。方法选择46例支气管哮喘急性发作期患者和18例健康者(对照组)为研究对象,根据支气管哮喘患者急性发作期病情严重程度分为3组,其中轻～中度患者18例、重度患者15例、危重度患者13例,测定3组患者治疗前、后及对照组的血浆合肽素、血常规等指标,比较4组受检者相关指标有无差异。结果治疗前危重度、重度、轻～中度支气管哮喘发作患者血浆合肽素水平分别为(1.08±0.21)μg/L、(0.72±0.16)μg/L、(0.46±0.10)μg/L,均明显高于对照组的(0.10±0.03)μg/L,差异有统计学意义(P<0.01);治疗前3组支气管哮喘患者血浆合肽素水平比较,差异有统计学意义(P<0.01)。治疗后危重度、重度、轻～中度患者血浆合肽素水平分别为(0.13±0.03)μg/L、(0.15±0.04)μg/L和(0.12±0.04)μg/L,与对照组比较,差异均无统计学意义(P>0.05)。支气管哮喘急性发作患者治疗前、治疗后血浆合肽素水平与PaO2均呈负相关(P<0.05),与PaCO2、血浆CRP水平、外周血白细胞总数均呈正相关(P<0.05)。结论血浆合肽素可作为判断支气管哮喘急性发作期患者病情严重程度及治疗疗效的一种观察指标。

Objective To explore the clinical significance of detecting plasma copeptin in patients with acute onset of bronchial asthma.Methods 46 patients with acute onset of bronchial asthma and 18 healthy volunteers in the control group were collected.The 46 patients were divided into mild～very severe grades with moderate grade patients including 18 cases,severe grade patients including 15 cases and very severe grade patients including 13 cases.Plasma copeptin,blood routine test and other markers were detected in the patients with acute onset of bronchial asthma before and after the treatment as well as the volunteers in the control group and then the difference of related data among four groups were compared.Results Plasma copeptin concentration of the very severe grade patients,severe grade patients and mild-moderate grade patients were （1.08±0.21）μg/L,（0.72±0.16）μg/L and （0.46±0.10）μg/L respectively before treatment,all of which were significantly higher than those of the control group,and the difference has statistical significance（P0.01）.The differences of plasma copeptin concentration compared each other among 3 groups with asthma acute onset before treatment were significant（All P0.01）.Plasma copeptin concentration of the very severe grade patients,severe grade patients and mild-moderate grade patients were 〔（0.13±0.03） μg/L〕,〔（0.15±0.04） μg/L〕and 〔（0.12±0.04） μg/L〕 respectively after treatment.Compared with the control group,the difference is not significant.For patients with acute onset of bronchial asthma both before and after treatment,there was a negative correlation between plasma copeptin concentrations and PaO2 （Both P0.05）,but positive correlation between the concentration and PaCO2,plasma CRP concentration and the total counts of white blood cells in blood （All P0.05）.Conclusion Plasma copeptin could be used as an indicator for judging the seriousness and the treatment efficacy of patients with acute onset of bronchial asthma.