慢性阻塞性肺疾病急性加重期血浆磷脂、C反应蛋白及纤维蛋白原含量的变化

Changes of plasma phospholipids levels, C-reactive protein and plasma fibrinogen in acute exacerbation of chronic obstructive pulmonary disease

目的 观察慢性阻塞性肺疾病急性加重期（AECOPD）患者血浆磷脂（PLs）、超敏C反应蛋白（hs-CRP）及血浆纤维蛋白原（Fbg）含量的变化及评估AECOPD的灵敏度。方法 收集2010年5月至2013年6月住院的65例AECOPD患者纳入本研究。60例年龄〉60岁的健康体检者作为对照组。观察治疗前后上述指标的变化,并与对照组进行比较。血浆PLs测定采用层析技术结合改良的无机磷定量方法。hs-CRP的测定采用免疫透射比浊法。结果 65例AECOPD患者治疗前血清hs-CRP水平（10.15±6.22）mg/L显著高于对照组（3.69±1.02）mg/L（P 〈0.01）及治疗后（6.36±5.72）mg/L（P 〈0.05）。治疗后血清hs-CRP 水平高于对照组（P 〈0.05）。AECOPD 患者治疗前Fbg水平（5.50±1.44）g/L显著高于对照组（2.96±0.87）g/L（P 〈0.01）及治疗后（4.03±1.25）g/L（P 〈0.01）。治疗后Fbg水平仍高于对照组（P 〈0.05）。血PLs、hs-CRP和Fbg含量评估AECOPD 的灵敏度分别为96.9%、76.9%和80.0%。PLs水平的灵敏度与hs-CRP及Fbg相比差异均有统计学意义（P 〈0.01）。结论 AECOPD患者血PLs、hs-CRP及Fbg含量均显著升高,血浆PLs水平对诊断及评估AECOPD有很高的灵敏度,有望成为AECOPD新的血浆生物标记物。

Objective To investigate the changes of plasma phospholipids （PLs） levels, high- sensitivity C reactive protein （hs-CRP） and plasma fibrinogen （Fbg） in patients with acute exacerbation of chronic obstructive pulmonary disease （AECOPD）. Methods A total of 65 patients with AECOPD, 60 cases healthy volunteers as control were enrolled into the study. The plasma PLs, hs-CRP and plasma fibrinogen levels were determined, peripheral blood samples were obtained during exacerbation and after recovery. Plasma PLs was assayed by measuring its inorganic phosphorus after separation by chromatograph. C-reactive protein was assessed by immunity transmission turbidity. Results Hs CRP levels were significantly increased in patients with AECOPD as compared with controls and stable COPD （ P 〈0.05）. Plasma fibrinogen levels were significantly increased in patients with AECOPD as compared with controls and stable COPD （ P 〈0.01）. PLs levels were significantly increased in AECOPD group comparing with controls and stable COPD （P 〈 0.01）. The sensitivity of PLs, hs-CRP and plasma fibrinogen for the prognosis of AECOPD were 96.9 %, 76.9 % and 80.0 % respectively. The sensitivity of PLs for the prognosis of AECOPD were significantly higher than hs-CRP or plasma fibrinogen （ P 〈0.01）. Conclusions Blood plasma fibrinogen, hs-CRP and PLs levels were significantly elevated in patients with AECOPD. The plasma PLs levels , for the diagnosis and evaluation of AECOPD, has high sensitivityand is expected to become the new plasma biomarkers of AECOPD.