急性发作期COPD合并呼吸衰竭老年患者的血清hs-CRP、GGT、CysC水平

Serum Levels of hs-CRP,GGT and CysC in Elderly Patients with Acute Exacerbation of COPD Complicated with Respiratory Failure

目的观察急性发作期合并呼吸衰竭的老年COPD患者外周血中的hs-CRP、GGT及CysC水平.方法回顾性分析80例老年COPD患者,其中出院后6个月内再次入院者即急性发作组40例、未发作组(稳定期)40例,比较组间首次出院时及急性发作组内患者不同时间节点的血清hs-CRP、GGT及CysC水平,观察其中差异以及变化规律.结果首次出院时急性发作组的hs-CRP、GGT及CysC水平显著高于未发作组患者(P<0.05);急性发作组患者在急性发作后的三项指标均显著高于首次出院时的水平(P<0.05),接受常规治疗后1 d、3 d、7 d,急性发作组患者的hs-CRP、GGT及CysC水平均有所下降,且呈现逐步下降的趋势,与此同时患者的肺功能水平FEV_(1)(%)、FEV_(1)/FVC则显著增高(P<0.05),即血清hs-CRP、GGT及CysC水平与FEV_(1)(%)、FEV_(1)/FVC呈现负相关.结论本文发现急性发作期且合并呼吸衰竭的老年COPD患者,其血清hs-CRP、GGT、CysC水平显著升高且呈现与病情进展、缓解相关的变化规律,首次出院时的血清hs-CRP、GGT、CysC水平具有一定的急性发作风险预测参考价值.

Objective To observe the levels of hs-CRP,GGT and CysC in peripheral blood of elderly COPD patients with acute exacerbation and respiratory failure.Methods 80 cases of elderly patients with COPD were retrospectively analyzed,including 40 cases of acute attack group and 40 cases of non attack group(stable period)who were re-admitted within 6 months after discharge.The serum levels of hs-CRP,GGT and CysC at different time points of first discharge and in acute attack group were compared,and the differences and changes were observed.Results The levels of hs-CRP,GGT and CysC in the acute attack group were significantly higher than those in the non attack group at the first discharge(P<0.05);the three indexes in the acute attack group after acute attack were significantly higher than those at the first discharge(P<0.05),1d,3d,7d after conventional treatment.In the acute attack group,the levels of hs-CRP,GGT and CysC decreased gradually,while the levels of FEV_(1)(%)and FEV_(1)/FVC increased significantly(P<0.05),that is,the serum levels of hs-CRP,GGT and CysC were negatively correlated with FEV_(1)(%)and FEV_(1)/FVC.Conclusion The serum levels of hs-CRP,GGT and CysC in elderly COPD patients with acute exacerbation and respiratory failure significantly increased,and the changes were related to the progress and remission of the disease.The serum levels of hs-CRP,GGT and CysC at the first discharge had a certain reference value for predicting the risk of acute exacerbation.