中国医师进修杂志
中國醫師進脩雜誌
중국의사진수잡지
CHINESE JOURNAL OF POSTGRADUATES OF MEDICINE
2008年
10期
41-43
,共3页
李楠%张彧%高冬娜%李锐
李楠%張彧%高鼕娜%李銳
리남%장욱%고동나%리예
呼吸窘迫综合征,成人%中性粒细胞弹性蛋白酶
呼吸窘迫綜閤徵,成人%中性粒細胞彈性蛋白酶
호흡군박종합정,성인%중성립세포탄성단백매
Respiratory distress syndrome,adult%Neutrophil elastase
目的 通过检测不同程度急性肺损伤(ALI)/急性呼吸窘迫综合征(ARDS)患者血清及支气管肺泡灌洗液(BALF)中中性粒细胞弹性蛋白酶(NE),探讨其对评价肺损伤严重程度和预后的临床指导意义.方法 将36例ALI/ARDS患者按氧合指数进行分组:A组氧合指数为201～300mm Hg(1 mm Hg=0.133 kPa),19例;B组为150～200 mm Hg,10例;C组为<150 mm Hg,7例.并选取健康对照者16例(对照组),各组均进行血清及BALF中NE测定.结果 A、B、C三组患者血清和BALF中NE分别为(1.76.4-0.63)nmol/L和(1.67±0.59)nmol/L、(3.26±0.51) nmol/L和(3.64±0.56)nmol/L、(4.56±0.68)nmol/L和(4.62±0.39)nmol/L,均明显高于对照组[(0.67±0.54)nmol/L和(0.62±0.48)nmol/L],差异均有统计学意义;死亡组患者血清及BALF中NE明显高于存活组(P＜0.01),而且ALI/ARDS患者的血清NE与氧合指数呈显著负相关性(r=-0.901,P＜0.01).结论 ALI/ARDS患者血清和BALF中NE明显升高,其水平与患者的肺损伤严重程度和预后密切相关.
目的 通過檢測不同程度急性肺損傷(ALI)/急性呼吸窘迫綜閤徵(ARDS)患者血清及支氣管肺泡灌洗液(BALF)中中性粒細胞彈性蛋白酶(NE),探討其對評價肺損傷嚴重程度和預後的臨床指導意義.方法 將36例ALI/ARDS患者按氧閤指數進行分組:A組氧閤指數為201～300mm Hg(1 mm Hg=0.133 kPa),19例;B組為150～200 mm Hg,10例;C組為<150 mm Hg,7例.併選取健康對照者16例(對照組),各組均進行血清及BALF中NE測定.結果 A、B、C三組患者血清和BALF中NE分彆為(1.76.4-0.63)nmol/L和(1.67±0.59)nmol/L、(3.26±0.51) nmol/L和(3.64±0.56)nmol/L、(4.56±0.68)nmol/L和(4.62±0.39)nmol/L,均明顯高于對照組[(0.67±0.54)nmol/L和(0.62±0.48)nmol/L],差異均有統計學意義;死亡組患者血清及BALF中NE明顯高于存活組(P＜0.01),而且ALI/ARDS患者的血清NE與氧閤指數呈顯著負相關性(r=-0.901,P＜0.01).結論 ALI/ARDS患者血清和BALF中NE明顯升高,其水平與患者的肺損傷嚴重程度和預後密切相關.
목적 통과검측불동정도급성폐손상(ALI)/급성호흡군박종합정(ARDS)환자혈청급지기관폐포관세액(BALF)중중성립세포탄성단백매(NE),탐토기대평개폐손상엄중정도화예후적림상지도의의.방법 장36례ALI/ARDS환자안양합지수진행분조:A조양합지수위201～300mm Hg(1 mm Hg=0.133 kPa),19례;B조위150～200 mm Hg,10례;C조위<150 mm Hg,7례.병선취건강대조자16례(대조조),각조균진행혈청급BALF중NE측정.결과 A、B、C삼조환자혈청화BALF중NE분별위(1.76.4-0.63)nmol/L화(1.67±0.59)nmol/L、(3.26±0.51) nmol/L화(3.64±0.56)nmol/L、(4.56±0.68)nmol/L화(4.62±0.39)nmol/L,균명현고우대조조[(0.67±0.54)nmol/L화(0.62±0.48)nmol/L],차이균유통계학의의;사망조환자혈청급BALF중NE명현고우존활조(P＜0.01),이차ALI/ARDS환자적혈청NE여양합지수정현저부상관성(r=-0.901,P＜0.01).결론 ALI/ARDS환자혈청화BALF중NE명현승고,기수평여환자적폐손상엄중정도화예후밀절상관.
Objective To investigate the neutrophil elastase (NE) in patients with acute lung injury (ALI)/acute respiratory distress syndrome (ARDS).Methods Thirty-six patients of ALI/ARDS and 16 healthy volunteers(control group)were involved in the study.The patients of ALI/ARDS were divided into three groups:group A (the oxygenation index was 201-300 mm Hg,1 mm Hg=0.133 kPa),group B (150-200 mm Hg),and group C (<150 mm Hg).The NE in serum and bronchoalveolar Lavage fluid (BALF) were measured.Results The NE in the serum and BALF in group A [(1.76±0.63)nmol/L and (1.67±0.59)nmol/L],group B [(3.26±0.51)nmol/L and (3.64±0.56)nmol/L] and group C [(4.56 ±0.68)nmol/L and (4.62±0.39)nmol/L] were much higher than that in control group [(0.67±0.54)nmol/L and (0.62±0.48)nmol/L].The NE in the serum and BALF of dead patients were higher than that in patients who were alive.Moreover,the NE in the patients of ALI/ARDS was inversely related to the oxygenation index (r=-0.901,P＜0.01). Conclusion The NE in patients of ALI/ARDS is higher than that in healthy people,and it is significantly related to the severity and the prognosis of ALI/ARDS.
