中国医师进修杂志
中國醫師進脩雜誌
중국의사진수잡지
CHINESE JOURNAL OF POSTGRADUATES OF MEDICINE
2013年
10期
7-11
,共5页
哮喘%C反应蛋白质%呼吸功能试验%哮喘控制测试%诱导痰
哮喘%C反應蛋白質%呼吸功能試驗%哮喘控製測試%誘導痰
효천%C반응단백질%호흡공능시험%효천공제측시%유도담
Asthma%C-reactive protein%Respiratory function%Asthma control test%Induced sputum
目的 研究支气管哮喘急性发作期患者血清超敏C反应蛋白(hs-CRP)与诱导痰白细胞分类计数、肺功能及哮喘控制测试(ACT)的相关性,探讨其临床应用价值.方法 收集支气管哮喘急性发作期患者30例(哮喘组),同时期健康体检者14例(对照组).测定对照组空腹血清hs-CRP和哮喘组经甲泼尼龙治疗5～7d前后的空腹血清hs-CRP.超声雾化4.5％氯化钠获取诱导痰,分别计算对照组、哮喘组治疗前后的嗜酸粒细胞百分比(EOS％)、中性粒细胞百分比、巨噬细胞百分比、淋巴细胞百分比.测定对照组、哮喘组治疗前后的肺功能.哮喘组进行ACT评分.利用Spearman相关分析判断血清hs-CRP与诱导痰白细胞分类计数、肺功能指标及ACT评分的相关性.利用受试者工作特征(ROC)曲线分析血清hs-CRP和诱导痰EOS％评估支气管哮喘急性发作期炎性反应水平的效能.结果 哮喘组有2例患者诱导痰失败排除本研究.哮喘组治疗前和治疗后血清hs-CRP均明显高于对照组[4.18(2.12～11.12)和1.48(1.03～4.81) mg/L比3.40(2.02 ～ 8.91) mg/L,H=18.939,P＜ 0.01],哮喘组治疗前血清hs-CRP明显高于治疗后(P＜0.01).治疗前,哮喘组血清hs-CRP与诱导痰EOS％呈正相关(r=0.849,P=0.000),与第1秒用力呼气容积占预计值百分比、第1秒用力呼气容积占用力肺活量比值、最大呼气中期流量占预计值百分比均呈负相关(r=-0.617,P=0.000;r=-0.559,P=0.002;r=-0.398,P=0.036),与ACT评分呈负相关(r=-0.511,P=0.005).血清hs-CRP的ROC曲线下面积为0.713,差异有统计学意义(P=0.003).结论 支气管哮喘急性发作期患者血清hs-CRP与诱导痰EOS％、肺功能、ACT评分具有良好相关性,是评价支气管哮喘系统性炎性反应水平的潜在标志物.
目的 研究支氣管哮喘急性髮作期患者血清超敏C反應蛋白(hs-CRP)與誘導痰白細胞分類計數、肺功能及哮喘控製測試(ACT)的相關性,探討其臨床應用價值.方法 收集支氣管哮喘急性髮作期患者30例(哮喘組),同時期健康體檢者14例(對照組).測定對照組空腹血清hs-CRP和哮喘組經甲潑尼龍治療5～7d前後的空腹血清hs-CRP.超聲霧化4.5％氯化鈉穫取誘導痰,分彆計算對照組、哮喘組治療前後的嗜痠粒細胞百分比(EOS％)、中性粒細胞百分比、巨噬細胞百分比、淋巴細胞百分比.測定對照組、哮喘組治療前後的肺功能.哮喘組進行ACT評分.利用Spearman相關分析判斷血清hs-CRP與誘導痰白細胞分類計數、肺功能指標及ACT評分的相關性.利用受試者工作特徵(ROC)麯線分析血清hs-CRP和誘導痰EOS％評估支氣管哮喘急性髮作期炎性反應水平的效能.結果 哮喘組有2例患者誘導痰失敗排除本研究.哮喘組治療前和治療後血清hs-CRP均明顯高于對照組[4.18(2.12～11.12)和1.48(1.03～4.81) mg/L比3.40(2.02 ～ 8.91) mg/L,H=18.939,P＜ 0.01],哮喘組治療前血清hs-CRP明顯高于治療後(P＜0.01).治療前,哮喘組血清hs-CRP與誘導痰EOS％呈正相關(r=0.849,P=0.000),與第1秒用力呼氣容積佔預計值百分比、第1秒用力呼氣容積佔用力肺活量比值、最大呼氣中期流量佔預計值百分比均呈負相關(r=-0.617,P=0.000;r=-0.559,P=0.002;r=-0.398,P=0.036),與ACT評分呈負相關(r=-0.511,P=0.005).血清hs-CRP的ROC麯線下麵積為0.713,差異有統計學意義(P=0.003).結論 支氣管哮喘急性髮作期患者血清hs-CRP與誘導痰EOS％、肺功能、ACT評分具有良好相關性,是評價支氣管哮喘繫統性炎性反應水平的潛在標誌物.
목적 연구지기관효천급성발작기환자혈청초민C반응단백(hs-CRP)여유도담백세포분류계수、폐공능급효천공제측시(ACT)적상관성,탐토기림상응용개치.방법 수집지기관효천급성발작기환자30례(효천조),동시기건강체검자14례(대조조).측정대조조공복혈청hs-CRP화효천조경갑발니룡치료5～7d전후적공복혈청hs-CRP.초성무화4.5％록화납획취유도담,분별계산대조조、효천조치료전후적기산립세포백분비(EOS％)、중성립세포백분비、거서세포백분비、림파세포백분비.측정대조조、효천조치료전후적폐공능.효천조진행ACT평분.이용Spearman상관분석판단혈청hs-CRP여유도담백세포분류계수、폐공능지표급ACT평분적상관성.이용수시자공작특정(ROC)곡선분석혈청hs-CRP화유도담EOS％평고지기관효천급성발작기염성반응수평적효능.결과 효천조유2례환자유도담실패배제본연구.효천조치료전화치료후혈청hs-CRP균명현고우대조조[4.18(2.12～11.12)화1.48(1.03～4.81) mg/L비3.40(2.02 ～ 8.91) mg/L,H=18.939,P＜ 0.01],효천조치료전혈청hs-CRP명현고우치료후(P＜0.01).치료전,효천조혈청hs-CRP여유도담EOS％정정상관(r=0.849,P=0.000),여제1초용력호기용적점예계치백분비、제1초용력호기용적점용력폐활량비치、최대호기중기류량점예계치백분비균정부상관(r=-0.617,P=0.000;r=-0.559,P=0.002;r=-0.398,P=0.036),여ACT평분정부상관(r=-0.511,P=0.005).혈청hs-CRP적ROC곡선하면적위0.713,차이유통계학의의(P=0.003).결론 지기관효천급성발작기환자혈청hs-CRP여유도담EOS％、폐공능、ACT평분구유량호상관성,시평개지기관효천계통성염성반응수평적잠재표지물.
Objective To study the correlation between the level of serum high sensitivity C-reactive protein (hs-CRP) and induced sputum cell counts,pulmonary function and asthma control test (ACT) in order to investigate the clinical application value of serum hs-CRP for the acute exacerbation bronchial asthma patients.Methods Thirty acute exacerbation bronchial asthma patients were collected as asthma group,14 healthy people during the same period were collected as control group.The fasting serum hs-CRP was examined in control group and before and after treatment of 5-7 d in asthma group.The induced sputum was obtained by ultrasonic atomizer 4.5％ sodium chloride,and the percentage of eosinophils (EOS％),neutrophil,macrophages,lymphocytes was calculated.The pulmonary function index was determined in control group and before and after treatment in asthma group.ACT score was performed in asthma group.The correlation between the serum hs-CRP and induced sputum differential leukocyte count,the pulmonary function index and ACT score was analyzed by Spearman correlation analysis.The effect of the serum hs-CRP and induced sputum EOS％ on inflammatory response of acute exacerbation bronchial asthma was evaluated by receiver operating characteristic (ROC) curve analysis.Results Two cases were excluded in asthma group.The serum hs-CRP before and after treatment in asthma group was higher than that in control group[4.18(2.12-11.12) and 3.40(2.02-8.91) mg/L vs.1.48(1.03-4.81) mg/L,H =18.939,P＜ 0.01].The serum hs-CRP before treatment was higher than that after treatment in asthma group (P ＜ 0.01).In asthma group,the serum hs-CRP had positive relationship with induced sputum EOS％ (r =0.849,P =0.000).There were negative correlations between the serum hs-CRP and the pulmonary function index such as one second forced expiratory volume percent predicted,one second forced expiratory volume occupied vital capacity ratio,maximum mid-expiratory flow percentage of predicted (r =-0.617,-0.559,-0.398,respectively,P =0.000,0.002,0.036,respectively).It was also found that the serum hs-CRP and ACT score had the remarkable Spearman linear correlation (r =-0.511,P =0.005).The area under the ROC curve of the serum hs-CRP was 0.713 (P =0.003).Conclusions There are significant correlations between the serum hs-CRP and induced sputum EOS％,pulmonary function,ACT score in the acute exacerbation bronchial asthma patients.It is found that hs-CRP could be considered as one of the potential marker to evaluate the systemic inflammation level of bronchial asthma.
