慢阻肺急性加重期早期合并细菌感染患者血浆氨基酸水平变化的分析

Analysis of plasma amino acid levels in patients with early COPD exacerbation complicated with bacterial infection

目的对比分析慢阻肺急性加重患者体内氨基酸水平的变化,并探索其临床应用价值。方法收集我院2017年1月-2019年1月于我院收治的慢阻肺急性加重期患者75例分为细菌感染组(A组)和非细菌感染组(B组),同期收集我院30例慢阻肺稳定期患者作为对照组(C组),检测三组患者体内必需氨基酸和非必需氨基酸水平的差异。结果在慢阻肺急性加重早期阶段,在A组患者甘氨酸、精氨酸的血浆水平低于C组,丙氨酸水平高于C组,差异具有统计学意义(P<0.05);B组和C组比较发现,总氨基酸和天冬酰胺、瓜氨酸、氨酰胺等13种氨基酸存在差异,差异具有统计学意义(P<0.05)。结论慢阻肺急性加重期患者住院时氨基酸水平的差异可能与细菌感染有关,天冬酰胺、瓜氨酸、谷氨酰胺、组氨酸、蛋氨酸、丝氨酸和苏氨酸等7种明显降低的氨基酸具有区分细菌和非细菌慢阻肺急性加重的潜在应用价值。

Objective To compare and analyze the changes of amino acid levels in patients with acute attack of COPD,and to explore its clinical application value.Methods 75 patients with AECOPD from January 2017 to January 2019 were divided into the bacterial infection group(the group A)and the non-bacterial infection group(ther group B).At the same time,30 patients with stable COPD were collected as the control group(the group C).The levels of essential and non-essential amino acids in the three groups were detected.Results In the early stage of AECOPD,the plasma levels of glycine and arginine in the group A were lower than those in the group C,and the levels of alanine were higher than those in the group C(P<0.05).Compared with the group B and group C,there were significant differences in total amino acids and 13 kinds of amino acids,such as asparagine,citrulline and ammonia(P<0.05).Conclusion The difference of amino acid levels during hospitalization of AECOPD may be related to bacterial infection.Seven significantly reduced amino acids,asparagine,citrulline,glutamine,histidine,methionine,serine and threonine have potential application value in differentiating bacterial from non-bacterial AECOPD.