慢性阻塞性肺疾病患者血清NE、α1-AT、CRP、PCT的表达及与肺功能的关系研究

Chronic Obstructive Pulmonary Disease: Expression of Serum Protease,Antiprotease, C-reactive Protein and Procalcitonin and Their Relationship with Pulmonary Function

目的:探讨慢性阻塞性肺疾病(COPD)患者血清中性粒细胞弹性蛋白酶(NE)、α1-抗胰蛋白酶(α1-AT)、C-反应蛋白(CRP)、降钙素原(PCT)的表达水平及其与肺功能的相关性。方法:选取2013年3月-2015年6月河北北方学院附属第一医院呼吸内科收治的COPD患者87例作为研究对象,其中急性加重期(急性组)患者49例,稳定期(稳定组)患者38例,另选取同时期在本院进行健康体检的志愿者30例为对照组,检测并对比急性组、稳定组和对照组受试者的血清NE、α1-AT、CRP、PCT水平及肺功能指标,并分析COPD患者NE、α1-AT、CRP、PCT水平与肺功能的相关性。结果:与对照组对比,急性组与稳定组患者的NE、CRP、PCT水平均明显升高,α1-AT水平明显降低(P<0.05),且急性组患者的NE、CRP、PCT水平高于稳定组,α1-AT水平低于稳定组(P<0.05);急性组与稳定组患者的第1秒用力呼气容积占预计值的百分比(FEV1%)、第1秒用力呼气容积/用力肺活量(FEV1/FVC)均低于对照组,且急性组FEV1%、FEV1/FVC低于稳定组(P<0.05);经Spearman相关性分析显示,NE、CRP、PCT与FEV1%及FEV1/FVC均呈负相关,α1-AT与FEV1%及FEV1/FVC呈正相关(P<0.05)。结论:COPD患者血清NE、CRP、PCT表达水平均明显升高,α1-AT表达水平明显降低,且NE、α1-AT、CRP、PCT均与肺功能存在一定相关性,加强对此类指标的监测有助于对COPD患者病情判断及治疗指导。

Objective： To investigate the expression of neutral granulocyte elastase（NE）, α1-antitrypsin（α1-AT）, C-reactive protein（CRP） and procalcitonin（PCT） in patients with chronic obstructive pulmonary disease（COPD） and its correlation with pulmonary function. Methods： A total of 87 COPD patients, who were treated in First Affiliated Hospital of Hebei North University from March2013 to June 2015, were chosen as subjects, among them, 49 cases were acute exacerbation（acute group）, 38 cases were stable phase（stable group）; another 30 volunteers, who underwent physical examination during the same period, were chosen as control group. The serum levels of NE, α1-AT, CRP, PCT and pulmonary function in the acute group, stable group and control group were detected and compared, the correlation of NE, α1-AT, CRP and PCT levels with pulmonary function in COPD patients was analyzed. Results： Compared with the control group, the levels of NE, CRP and PCT in the acute group and the stable group were significantly increased, and the level of α1-AT was significantly lower（P〈0.05）; the levels of NE, CRP and PCT in the acute group were higher than those in the stable group, and the level of α1-AT was lower than that in the stable group（P〈0.05）. Percentage of forced expiratory volume at first second to predicted value（FEV1%） and forced expiratory volume at first second to forced vital capacity（FEV1/FVC） in the acute and the stable group were lower than those in the control group, FEV1%, FEV1/FVC in the acute group was lower than that in the stable group（P〈0.05）. Spearman correlation analysis showed that NE, CRP and PCT were negatively correlated with FEV1% and FEV1/FVC, and α1-AT was positively correlated with FEV1% and FEV1/FVC（P〈0.05）. Conclusion： The levels of serum NE, CRP and PCT in the patients with COPD are significantly increased, the expression level of α1-AT is obviously decreased, and NE, α1-AT, CRP and PCT are related to pulmonary function. To strengthen the monitoring of such indicators is helpful for the diagnosis and treatment of COPD patients.