慢性阻塞性肺疾病急性加重患者MCP-1、TF水平及临床意义

Expression and clinical significance of serum monocyte chemoattractant protein-1,tissue factor in patients with acute exacerbations of chronic obstructive pulmonary disease

目的探讨慢性阻塞性肺疾病急性加重(AECOPD)患者单核细胞趋化蛋白-1(monocyte chemoattractant protein-1,MCP-1)与组织因子(tissue factor,TF)的变化及临床意义。方法 49例AECOPD患者和健康对照组30例,年龄分别为62.8±6.5和70.8±10.8岁。AECOPD组按降钙素原(procalcitonin,PCT)水平分为PCT≥0.5μg/L组19例和PCT<0.5μg/L组30例两个亚组。采用ELISA方法检测血浆TF、MCP-1及PCT。结果 AECOPD组及其各亚组TF、MCP-1均显著高于健康对照组(P<0.01);且各组TF与MCP-1呈直线正相关。亚组间PCT≥0.5μg/L组TF及MCP-1较PCT<0.5μg/L组增高,差异有显著性(P<0.05)。结论 AECOPD患者存在激活的高凝状态,PCT增高者更重。AECOPD患者血浆TF增高受MCP-1水平的影响,监测其水平对AECOPD患者血液高凝状态及心脑血管血栓性疾病的防治有重要意义。

Objective To investigate the changes and clinical significance of monocyte chemoattractant protein-1（MCP-1） and tissue factor（TF） in patients with acute exacerbations of chronic obstructive pulmonary disease. Methods Forty-nine patients with AECOPD and 30 healthy controls were enrolled in this study.ELISA was used to detect plasma TF,MCP-1 and procalcitonin（PCT）.AECOPD group was subgrouped into PCT increase group（n=19） and normal PCT group（n=30）. Results TF,MCP-1 in AECOPD group were significantly higher than in healthy control group（P0.01）.There was a linear positive correlation between TF and MCP-1 in AECOPD patients.The levels of TF and MCP-1 were higher in PCT≥0.5 μg/L group than that in PCT0.5 μg/L group（P0.05）. Conclusion High condensation state is activated in AECOPD patients,especially in the patients with PCT increase.To monitor the plasma TF and MCP-1 levels are important for AECOPD patients with hypercoagulability state to prevent their cardiovascular and cerebrovascular thrombotic diseases.