CAJ | 학술논문

目的：观察COPD机械通气患者肺泡灌洗液( BALF)中肺表面活性物质相关蛋白D ( SP-D)及白介素-6(IL-6)的水平。方法40例COPD机械通气患者根据入院第ld和第5d的APACHE II评分变化,分为病情加重组(17例),及病情缓解组(23例),收集机械通气1、5d的肺泡灌洗液,测定BALF中SP-D、IL-6浓度,观察不同预后患者BALF中SP-D、IL-6水平的差异。结果病情缓解组BALF中SP-D含量逐渐上升,机械通气5d较1d明显升高(P<0．05)；与病情缓解组比较,病情加重组机械通气1d、5d BALF中SP-D含量均明显降低(P<0．05)。病情缓解组BALF中IL-6含量逐渐下降,病情加重组BALF中IL-6含量逐渐上升(P<0．05)。相关分析显示BALF中SP-D浓度与IL-6含量及APACHE II评分均呈负相关性( r分别为-0．35,-0．41,均P<0．05)。结论 SP-D、IL-6在COPD患者的发生发展中起重要的作用,BALF中SP-D、IL-6可作为COPD机械通气患者病情监测和预后的参考指标。
목적：관찰COPD궤계통기환자폐포관세액( BALF)중폐표면활성물질상관단백D ( SP-D)급백개소-6(IL-6)적수평。방법40례COPD궤계통기환자근거입원제ld화제5d적APACHE II평분변화,분위병정가중조(17례),급병정완해조(23례),수집궤계통기1、5d적폐포관세액,측정BALF중SP-D、IL-6농도,관찰불동예후환자BALF중SP-D、IL-6수평적차이。결과병정완해조BALF중SP-D함량축점상승,궤계통기5d교1d명현승고(P<0．05)；여병정완해조비교,병정가중조궤계통기1d、5d BALF중SP-D함량균명현강저(P<0．05)。병정완해조BALF중IL-6함량축점하강,병정가중조BALF중IL-6함량축점상승(P<0．05)。상관분석현시BALF중SP-D농도여IL-6함량급APACHE II평분균정부상관성( r분별위-0．35,-0．41,균P<0．05)。결론 SP-D、IL-6재COPD환자적발생발전중기중요적작용,BALF중SP-D、IL-6가작위COPD궤계통기환자병정감측화예후적삼고지표。
Objective To investigate the concentration of pulmonary surfactant-associated protein D ( SP-D) and interleukin-6 (IL-6) in the bronchoalveolar lavage fluid (BALF) of COPD patients undergoing mechanical venti-lation ( MV) . Methods 40 patients with COPD undergoing MV were involved in the study. According to the A-PACHE II score, the patients were divided into the remission group ( n=23 ) and the worsening group ( n=17 ) . BALF was collected on the 1st and 5th days after MV. The content of IL-6 and SP-D in BALF was measured by ELISA. The levels of IL-6 and SP-D in BALF of the patients with different severity were compared. Results The level of SP-D was significantly higher on the 5th day than on the 1st day in the remission group, and it decreased more obviously in the worsening group (P<0. 05). The level of IL-6 decreased gradually in the remission group but increased gradually in the worsening group. The level of SP-D was negatively correlated with IL-6 level and APACHE II score. Conclusion The findings suggest that the levels of SP-D and IL-6 in BALF are correlated with prognosis of COPD patients undergoing MV, and it may prove to be useful as a guidance of therapy and prognosis.