国际呼吸杂志
國際呼吸雜誌
국제호흡잡지
INTERNATIONAL JOURNAL OF RESPIRATION
2011年
4期
266-269
,共4页
姜美妮%杜永成%韩葆芬%胡晓芸
薑美妮%杜永成%韓葆芬%鬍曉蕓
강미니%두영성%한보분%호효예
慢性阻塞性肺疾病%C反应蛋白%组织型纤溶酶原激活物%纤溶酶原激活剂抑制物-1
慢性阻塞性肺疾病%C反應蛋白%組織型纖溶酶原激活物%纖溶酶原激活劑抑製物-1
만성조새성폐질병%C반응단백%조직형섬용매원격활물%섬용매원격활제억제물-1
Chronic obstructive pulmonary disease%C-reactive protein%Tissue-type plasminogen activator%Plasminogen activator inhibitor-1
目的 观察慢性阻塞性肺疾病(COPD)患者纤溶功能异常及其与C反应蛋白(CRP)的关系.方法 选择2009年7月至2010年3月在山西医科大学第一医院呼吸科住院的COPD急性加重(AECOPD)患者121例,常规行血细胞分析.选择其中30例患者作为AECOPD组,该30例患者病情缓解后作为COPD缓解期组,本院同期健康体检者20例为健康对照组.ELISA法测定三组血浆C反应蛋白(CRP)、组织型纤溶酶原激活物及纤溶酶原激活剂抑制物-1(PAI-1)水平.121例AECOPD患者中的90例经知情同意后行双下肢深静脉超声检查,疑诊肺血栓栓塞症者进一步行螺旋CT肺动脉造影检查.结果 121例AECOPD患者中外周血白细胞计数升高者32例(26.4%).90例双下肢深静脉超声检查结果中合并深静脉血栓形成者9例(10.0%),同时合并肺血栓栓塞症者2例(2.2%).与健康对照组比较,AECOPD组、COPD缓解期组血浆CRP及PAI-1显著升高(P＜0.001),t-PA显著降低(P＜0.001).AECOPD组血浆CRP、PAI-1均较COPD缓解期组升高(P＜0.001),t-PA较COPD缓解期组降低(P＜0.001).AECOPD组血浆CRP与PAI-I呈正相关(r=0.871,P＜0.001),与t-PA呈负相关(r=-0.587,P＜0.001).结论 AECOPD患者存在纤溶功能异常及CRP升高,CRP可能是纤溶功能紊乱的预测指标.
目的 觀察慢性阻塞性肺疾病(COPD)患者纖溶功能異常及其與C反應蛋白(CRP)的關繫.方法 選擇2009年7月至2010年3月在山西醫科大學第一醫院呼吸科住院的COPD急性加重(AECOPD)患者121例,常規行血細胞分析.選擇其中30例患者作為AECOPD組,該30例患者病情緩解後作為COPD緩解期組,本院同期健康體檢者20例為健康對照組.ELISA法測定三組血漿C反應蛋白(CRP)、組織型纖溶酶原激活物及纖溶酶原激活劑抑製物-1(PAI-1)水平.121例AECOPD患者中的90例經知情同意後行雙下肢深靜脈超聲檢查,疑診肺血栓栓塞癥者進一步行螺鏇CT肺動脈造影檢查.結果 121例AECOPD患者中外週血白細胞計數升高者32例(26.4%).90例雙下肢深靜脈超聲檢查結果中閤併深靜脈血栓形成者9例(10.0%),同時閤併肺血栓栓塞癥者2例(2.2%).與健康對照組比較,AECOPD組、COPD緩解期組血漿CRP及PAI-1顯著升高(P＜0.001),t-PA顯著降低(P＜0.001).AECOPD組血漿CRP、PAI-1均較COPD緩解期組升高(P＜0.001),t-PA較COPD緩解期組降低(P＜0.001).AECOPD組血漿CRP與PAI-I呈正相關(r=0.871,P＜0.001),與t-PA呈負相關(r=-0.587,P＜0.001).結論 AECOPD患者存在纖溶功能異常及CRP升高,CRP可能是纖溶功能紊亂的預測指標.
목적 관찰만성조새성폐질병(COPD)환자섬용공능이상급기여C반응단백(CRP)적관계.방법 선택2009년7월지2010년3월재산서의과대학제일의원호흡과주원적COPD급성가중(AECOPD)환자121례,상규행혈세포분석.선택기중30례환자작위AECOPD조,해30례환자병정완해후작위COPD완해기조,본원동기건강체검자20례위건강대조조.ELISA법측정삼조혈장C반응단백(CRP)、조직형섬용매원격활물급섬용매원격활제억제물-1(PAI-1)수평.121례AECOPD환자중적90례경지정동의후행쌍하지심정맥초성검사,의진폐혈전전새증자진일보행라선CT폐동맥조영검사.결과 121례AECOPD환자중외주혈백세포계수승고자32례(26.4%).90례쌍하지심정맥초성검사결과중합병심정맥혈전형성자9례(10.0%),동시합병폐혈전전새증자2례(2.2%).여건강대조조비교,AECOPD조、COPD완해기조혈장CRP급PAI-1현저승고(P＜0.001),t-PA현저강저(P＜0.001).AECOPD조혈장CRP、PAI-1균교COPD완해기조승고(P＜0.001),t-PA교COPD완해기조강저(P＜0.001).AECOPD조혈장CRP여PAI-I정정상관(r=0.871,P＜0.001),여t-PA정부상관(r=-0.587,P＜0.001).결론 AECOPD환자존재섬용공능이상급CRP승고,CRP가능시섬용공능문란적예측지표.
Objective To investigate abnormality of fibrinolysis system in patients with chronic obstructive pulmonary disease (COPD)and the relationship of C-reactive protein (CRP) with it. Methods White blood cell from 121 patients with acute exacerbations of chronic obstructive pulmonary disease (AECOPD) was detected. Among them, 30 patients were selected as AECOPD group. When their illness alleviated, they were enrolled in COPD paracmasis group. 20 healthy individuals were enrolled in control group. The plasma levels of CRP, tissue plasminogen activator (t-PA) and plasminogen activator inhibitor-1 (PAI-1) were measured by enzyme linked immunosorbent assay. 90 cases of AECOPD underwent deep venous ultrasonography of both lower limbs. Spiral CT pulmonary angiography was further performed in the patients suspected as pulmonary thromboembolism. Results In 121 patients with AECOPD, peripheral white blood cell count of 32 cases (26.4 %) increased. In 90 patients examined by deep venous ultrasonography of both lower limbs,nine cases (10.0%) accompanied deep vein thrombosis,two cases (2.2 % ) accompanied pulmonary thromboembolism. Compared with control group, the levels of CRP and PAI-1 significantly increased and t-PA significantly decreased in AECOPD group and COPD paracmasis group (all P ＜0.001). The levels of CRP and PAI-1 in AECOPD group were significantly higher than those in COPD paracmasis group ( P ＜ 0.001), while t-PA was significantly lower in AECOPD group than that in COPD paracmasis group ( P ＜0.001). CRP was positively correlated with PAI-1 ( r = 0.871, P ＜0.001) and negatively correlated with t-PA ( r = -0.587, P ＜0.001).Conclusions AECOPD patients have abnormal fibrinolysis and high level of CRP. CRP may be a predictor of fibrinolytic dysfunction.
