血清淀粉样蛋白A在支气管哮喘诊治中的临床价值

Clinical value of serum amyloid A protein in bronchial asthma

目的探讨血清淀粉样蛋白A(SAA)在支气管哮喘急性发作时的水平变化及与哮喘严重程度的关系。方法选择符合哮喘诊断标准排除其他疾病的71例支气管哮喘急性发作患者,根据哮喘急性发作因素分成病毒感染组23例、过敏组24例、细菌感染组24例。测定三组患者血清中SAA水平及校正年龄和性别后的第1秒用力呼气量(FEV1)%预测值。运用秩和检验比较三组间SAA水平、FEV1%预测值的差异,采用Spearman相关分析研究SAA水平与FEV1%预测值的关系。结果细菌感染组的SAA水平明显高于病毒感染组及过敏组,病毒感染组SAA水平较过敏组增加,差异均有统计学意义(Z分别=-4.40、-5.10、-2.14,P均<0.05);三组间FEV1%的预测值比较,差异无统计学意义(χ2=0.72,P>0.05)。细菌感染组SAA水平与FEV1%的预测值呈负相关(r=-0.81,P<0.05);病毒感染组、过敏组SAA水平与FEV1%的预测值无相关性(r分别=-0.07、-0.08,P均>0.05)。结论 SAA对于区分哮喘诱因有一定的临床应用价值;当为细菌感染诱发的哮喘时,SAA还可以用于评估哮喘严重程度。

Objective To explore the changes of serum amyloid A（SAA） protein when the bronchial asthma acute attack and its relationship with the severity of asthma. Methods Totally 71 cases with bronchial asthma acute attack who were diagnosed bronchial asthma and excluded other diseases were divided into viral infection group（23 cases）,allergy group（24 cases）,and bacterial infection group（24 cases） according to the triggering factors of acute bronchial asthma. The level of SAA and forced expiratory volume in 1 second（FEV1）% predicted value with modified age and sex were detected and the relationship between SAA level and FEV1% predicted value was analyzed by spearman correlation analysis. Results The level of SAA of bacterial infection group were significantly higher than that of virus infection group and allergy group（Z=-4.40,-5.10,P〈0.05）. The level of SAA of virus infection group was higher than that of allergy group（Z=-2.14,P〈0.05）.There was no statistical difference of FEV1% predicted value among three groups（χ~2=0.72,P〉0.05）.The SAA level was negatively associated with FEV1% predicted value in bacterial infection group（r=-0.81,P〈0.05）. There was no correlation between the level of SAA and FEV1% predicted value both in viral infection group and allergy group（r=-0.07,-0.08,P〉0.05）. Conclusion The level of SAA have some clinical value in differentiating asthma triggering factors,and SAA can also be used to assess the severity of asthma when induced by bacterial infection.