摘要
目的探讨血清淀粉样蛋白A在慢性阻塞性肺疾病急性加重期的变化及其意义,为临床诊疗提供参考。方法选取我院接诊的慢性阻塞性肺疾病急性加重期患者70例,将其分为A组(AECOPD I级)38例和B组(AECOPDⅡ/Ⅲ级)32例,选取同期在我院体检的健康人群30例为健康对照组。对比急性加重期患者、稳定期患者以及健康对照组受试者的血清淀粉样蛋白A以及C-反应蛋白(CRP)水平;对比A组和B组患者的血清淀粉样蛋白A和CRP两个指标的敏感度和特异度;分析痰培养结果和血清淀粉样蛋白A和CRP水平的关系。结果稳定期和急性加重期患者的血清淀粉样蛋白A以及CRP水平均显著高于健康对照组(均P<0.05);急性加重期的血清淀粉样蛋白A以及CRP水平均显著高于稳定期(均P<0.05);慢性阻塞性肺疾病患者血清淀粉样蛋白A水平显著高于CRP水平(P<0.05);B组的血清淀粉样蛋白A在区分急性加重期和稳定期的敏感度和特异度为84%、91%,AUC值=0.92,优于CRP的敏感度和特异度(69%、69%,AUC值=0.79);有脓性痰或者痰培养结果阳性患者的血清淀粉样蛋白A水平为(79.36±15.72)mg/L,CRP水平为(24.97±6.52)mg/L,均显著高于没有脓性痰且痰培养结果阴性的患者(均P<0.05)。结论检测血清淀粉样蛋白A对判断慢性阻塞性肺疾病患者病情严重程度有一定的指导意义,同时可以指导临床更有针对性地应用和停用抗生素,值得在临床上进一步推广应用。
Objective To investigate the value of serum amyloid protein A in acute exacerbation chronic obstructive pulmonary disease. Methods 70 patients of acute exacerbation chronic obstructive pulmonary disease(AECOPD) were divided into group A (38 cases of AECOPD I level) and group B (32 cases of AECOPD II/III level). Selected 30 cases of healthy people as healthy control group in the same period. Compared the level of serum amyloid protein A and C-reactive protein in group of acute exacerbation, group of stable patients and group of healthy. Compared sensitivity and specificity of serum amyloid A and C-reactive protein in group A and group B. Analyzed the relationship between the results of sputum culture and serum amyloid A and C-reactive protein levels. Results The levels of serum amyloid A and C-reactive protein in stable and acute exacerbation were significantly higher than that of the healthy control group (P〈0.05). Acute exacerbation of serum amyloid A and C-reactive protein levels were significantly higher than that of stable group (all P〈0.05). The levels of serum amyloid A were significantly higher than C-reactive protein in patients with chronic obstructive pulmonary disease (P〈O.05). The sensitivity and specificity of serum amyloid protein A in identifying acute exacerbation and stable of group B were 84% and 91% ,AUC value=0.92,were superior than C-reactive protein (69%, 69% ,AUC value=0.79). The levels of serum amyloid A were (79.36± 15.72)mg/L in patients of purulent sputum or positivity of sputum culture, the levels of C-reactive protein were (24.97±6.52) mg/L. All were significantly higher than that of no purulent sputum and the result of sputum culture negative patients (all P〈0.05 ). Conclusion The detection of serum amyloid A has certain directive significance to the judgment of patients with chronic obstructive pulmonary disease severity,and can guide clinical targeted application and discontinuation of antibiotics,worthy of further application in clinical practice.
出处
《中国现代医药杂志》
2014年第2期23-26,共4页
Modern Medicine Journal of China
基金
广东省东莞市科技项目(编号:201110515000098)