稳定期COPD患者支气管肺泡灌洗液中表面活性蛋白D水平及意义

Level and Significance of Surfactant Protein D in Bronchoalveolar Lavage fluid of COPD Patients During the Slationary Phase

目的探讨慢性阻塞性肺疾病(COPD)患者支气管肺泡灌洗液中表面活性蛋白D(SP-D)水平和意义。方法便利选取2013年5月—2015年5月期间重庆市第七人民医院收治的稳定期COPD患者62例作为观察组,采用ELISA法测定支气管肺泡灌洗液(BALF)中的SP-D水平,另选取62例疑诊肺部疾病但肺部检查并没有出现异常的患者作为对照A组以及62例肺炎患者作为对照B组,分别用同样方法进行BALF中的SP-D水平测定,然后分析观察组及对照组患者的肺功能指标,包括FEV1%、FEV1/FVC,以及血清CRP的水平及与吸烟指数的关系。结果观察组的SP-D水平比对照A组及对照B组明显偏低(P<0.05);观察组患者的BALF中SP-D水平与肺功能指标FEV1%、FEV1/FVC均呈现正相关性,相应指数分别为r=0.191 1、0.764 6。而与血清中的CRP水平以及吸烟指数呈现负相关性,相应指数为r=-0.936 6;r=-0.798。对照A组以及对照B组SP-D水平与肺功能、血清中的CRP水平及吸烟指数均表现为负相关性,相应指数分别为r=-0.583 7、-0.938 8;r=-0.890 3、-0838 8。结论 SP-D可能参与了COPD的炎症发病机制,可作为对COPD严重程度进行监测和评估的生物标记物。

Objective To study the level and significance of surfactant protein D in bronchoalveolar lavage fluid of COPD patients during the slationary phase. Methods Convenient selection 62 cases of patients from Chongging Seventh people,s Hspitnl with COPD during the slationary phase in our hospital from May 2013 to May 2015 were selected as the observation group, and the SP-D level was measured by the ELISA method, and 62 cases suspected with the pulmonary diseases but without abnormalities were selected as the control A group, and 62 cases of patients with pneumonia were selected as the control B group, and measured by the same method, and then the pulmonary function index of the two groups was observed, including FEV1%, FEV1/FVC, serum CRP level and correlation with smoking index. Results The SP-D level was obviously lower than that in the control A group and control B group（P0.05）, the SP-D level in BALF was positively correlated with the pulmonary function indexes of FEV1% and FEV1/FVC, and the corresponding indexes were respectively r=0.191 1; r=0.764 6, and negatively correlated with the CRP level in serum and smoking index, and the corresponding indexes were respectively r=-0.936 6; r=-0.798, and the SP-D level in the control A group and control B group was negatively correlated with the pulmonary function, CRP level in serum and smoking index, and the corresponding indexes were respectively r=-0.583 7,-0.938 8; r=-0.890 3,-0838 8. Conclusion SP-D may be involved in the pathogenesis of COPD inflammation, which can be used as the biomarker of monitoring and evaluating the severity of COPD.