实用心脑肺血管病杂志
實用心腦肺血管病雜誌
실용심뇌폐혈관병잡지
Practical Journal of Cardiac Cerebral Pneumal and Vascular Disease
2015年
9期
33-36
,共4页
王会卿%尹刚%刘军霞%刘才锐
王會卿%尹剛%劉軍霞%劉纔銳
왕회경%윤강%류군하%류재예
肺疾病,慢性阻塞性%胱抑素 C%预后
肺疾病,慢性阻塞性%胱抑素 C%預後
폐질병,만성조새성%광억소 C%예후
Pulmonary disease,chronic obstructive%Cystatin C%Prognosis
目的：观察慢性阻塞性肺疾病急性加重期（AECOPD）患者血清胱抑素 C（Cys - C）水平变化，探究其临床意义。方法选取定州市妇幼保健院2012—2014年收治的50例 AECOPD 患者作为 AECOPD 组，选取同期定州市妇幼保健院门诊随访的50例 COPD 稳定期患者作为对照组。比较两组患者白细胞计数、中性粒细胞分数、C 反应蛋白（CRP）水平、第一秒用力呼气容积（ FEV1）、用力肺活量（ FVC）、一秒率（ FEV1/ FVC）、最大呼气中期流量（MMEF）及血清 Cys - C、肌酐、尿素氮水平和肾小球滤过率（GFR）；根据血清 Cys - C 水平将 AECOPD 组患者分为Cys - C 增高组37例和 Cys - C 正常组13例，比较两亚组患者以上指标，并分析 Cys - C 与其他指标的相关性。结果两组患者血清尿素氮水平及 GFR 比较，差异无统计学意义（P >0.05）；AECOPD 组患者白细胞计数、中性粒细胞分数、CRP 水平及血清 Cys - C、肌酐水平高于对照组，FEV1、FVC、FEV1/ FVC、MMEF 低于对照组（P <0.05）。两亚组患者血清尿素氮水平比较，差异无统计学意义（ P >0.05）；Cys - C 增高组患者白细胞计数、中性粒细胞分数、CRP、血清 Cys - C 及肌酐水平高于 Cys - C 正常组，FEV1、FVC、FEV1/ FVC、MMEF、GFR 低于 Cys - C 正常组（P <0.05）。Pearson 相关性分析结果显示，Cys - C 与白细胞计数、中性粒细胞分数、尿素氮、GFR 无直线相关性（r 值分别为0.258、0.174、0.431、-0.069，P 值分别为0.067、0.056、0.075、0.710）；Cys - C 与 CRP、肌酐呈正相关（r值分别为0.668、0.189，P 值分别为0.007、0.017），与 FEV1、FVC、FEV1/ FVC、MMEF 呈负相关（ r 值分别为-0.515、-0.642、-0.459、-0.413，P 值分别为0.009、0.013、0.025、0.031）。结论 AECOPD 患者血清 Cys - C水平较高，且随 COPD 病情变化而变化，监测血清 Cys - C 水平变化能有效评估 COPD 患者病情、治疗效果及预测其预后。
目的：觀察慢性阻塞性肺疾病急性加重期（AECOPD）患者血清胱抑素 C（Cys - C）水平變化，探究其臨床意義。方法選取定州市婦幼保健院2012—2014年收治的50例 AECOPD 患者作為 AECOPD 組，選取同期定州市婦幼保健院門診隨訪的50例 COPD 穩定期患者作為對照組。比較兩組患者白細胞計數、中性粒細胞分數、C 反應蛋白（CRP）水平、第一秒用力呼氣容積（ FEV1）、用力肺活量（ FVC）、一秒率（ FEV1/ FVC）、最大呼氣中期流量（MMEF）及血清 Cys - C、肌酐、尿素氮水平和腎小毬濾過率（GFR）；根據血清 Cys - C 水平將 AECOPD 組患者分為Cys - C 增高組37例和 Cys - C 正常組13例，比較兩亞組患者以上指標，併分析 Cys - C 與其他指標的相關性。結果兩組患者血清尿素氮水平及 GFR 比較，差異無統計學意義（P >0.05）；AECOPD 組患者白細胞計數、中性粒細胞分數、CRP 水平及血清 Cys - C、肌酐水平高于對照組，FEV1、FVC、FEV1/ FVC、MMEF 低于對照組（P <0.05）。兩亞組患者血清尿素氮水平比較，差異無統計學意義（ P >0.05）；Cys - C 增高組患者白細胞計數、中性粒細胞分數、CRP、血清 Cys - C 及肌酐水平高于 Cys - C 正常組，FEV1、FVC、FEV1/ FVC、MMEF、GFR 低于 Cys - C 正常組（P <0.05）。Pearson 相關性分析結果顯示，Cys - C 與白細胞計數、中性粒細胞分數、尿素氮、GFR 無直線相關性（r 值分彆為0.258、0.174、0.431、-0.069，P 值分彆為0.067、0.056、0.075、0.710）；Cys - C 與 CRP、肌酐呈正相關（r值分彆為0.668、0.189，P 值分彆為0.007、0.017），與 FEV1、FVC、FEV1/ FVC、MMEF 呈負相關（ r 值分彆為-0.515、-0.642、-0.459、-0.413，P 值分彆為0.009、0.013、0.025、0.031）。結論 AECOPD 患者血清 Cys - C水平較高，且隨 COPD 病情變化而變化，鑑測血清 Cys - C 水平變化能有效評估 COPD 患者病情、治療效果及預測其預後。
목적：관찰만성조새성폐질병급성가중기（AECOPD）환자혈청광억소 C（Cys - C）수평변화，탐구기림상의의。방법선취정주시부유보건원2012—2014년수치적50례 AECOPD 환자작위 AECOPD 조，선취동기정주시부유보건원문진수방적50례 COPD 은정기환자작위대조조。비교량조환자백세포계수、중성립세포분수、C 반응단백（CRP）수평、제일초용력호기용적（ FEV1）、용력폐활량（ FVC）、일초솔（ FEV1/ FVC）、최대호기중기류량（MMEF）급혈청 Cys - C、기항、뇨소담수평화신소구려과솔（GFR）；근거혈청 Cys - C 수평장 AECOPD 조환자분위Cys - C 증고조37례화 Cys - C 정상조13례，비교량아조환자이상지표，병분석 Cys - C 여기타지표적상관성。결과량조환자혈청뇨소담수평급 GFR 비교，차이무통계학의의（P >0.05）；AECOPD 조환자백세포계수、중성립세포분수、CRP 수평급혈청 Cys - C、기항수평고우대조조，FEV1、FVC、FEV1/ FVC、MMEF 저우대조조（P <0.05）。량아조환자혈청뇨소담수평비교，차이무통계학의의（ P >0.05）；Cys - C 증고조환자백세포계수、중성립세포분수、CRP、혈청 Cys - C 급기항수평고우 Cys - C 정상조，FEV1、FVC、FEV1/ FVC、MMEF、GFR 저우 Cys - C 정상조（P <0.05）。Pearson 상관성분석결과현시，Cys - C 여백세포계수、중성립세포분수、뇨소담、GFR 무직선상관성（r 치분별위0.258、0.174、0.431、-0.069，P 치분별위0.067、0.056、0.075、0.710）；Cys - C 여 CRP、기항정정상관（r치분별위0.668、0.189，P 치분별위0.007、0.017），여 FEV1、FVC、FEV1/ FVC、MMEF 정부상관（ r 치분별위-0.515、-0.642、-0.459、-0.413，P 치분별위0.009、0.013、0.025、0.031）。결론 AECOPD 환자혈청 Cys - C수평교고，차수 COPD 병정변화이변화，감측혈청 Cys - C 수평변화능유효평고 COPD 환자병정、치료효과급예측기예후。
Objective To observe the change of serum cystatin - C level of patients with acute exacerbation of chronic obstructive pulmonary disease(AECOPD),to explore its clinical significance. Methods A total of 50 patients with AECOPD were selected as case group in Maternal and Child Health Care Center of Dingzhou from 2012 to 2014,a total of 50 outpatients with stable COPD were selected as control group at the same time,WBC,neutrophils percentage,serum CRP level,FEV1 , FVC,FEV1 / FVC,MMEF,serum levels of Cys - C,Cr and BUN,GFR were compared between the two groups. According to serum Cys - C level,patients of case group were divided into A group(with elevated serum Cys - C level,n = 37)and B group (with normal serum Cys - C level,n = 13),above index was compared between the two subgroups,and correlations between Cys - C and other observation index were analyzed. Results No statistically significant differences of serum BUN level or GFR was found between control group and case group(P > 0. 05);WBC,neutrophils percentage,serum levels of CRP,Cys - C and Cr of case group were statistically significantly higher than those of control group,while FEV1 ,FVC,FEV1 / FVC and MMEF of case group were statistically significantly lower than those of control group( P < 0. 05). No statistically significant differences of serum BUN level was found between A group and B group(P > 0. 05);WBC,neutrophils percentage,serum levels of CRP,Cys - C and Cr of A group were statistically significantly higher than those of B group,while FEV1 ,FVC, FEV1 / FVC,MMEF and GFR of A group were statistically significantly lower than those of B group( P < 0. 05). Pearson correlation analysis showed that,Cys - C was not linearly correlated with WBC ( r = 0. 258,P = 0. 067 ),neutrophils percentage(r = 0. 174,P = 0. 056),BUN(r = 0. 431,P = 0. 075)or GFR(r = - 0. 069,P = 0. 710),while Cys - C was positively correlated with CRP(r = 0. 668,P = 0. 007),Cr(r = 0. 189,P = 0. 017),respectively,was negatively correlated with FEV1 (r = - 0. 515,P = 0. 009),FVC(r = - 0. 642,P = 0. 013),FEV1 / FVC(r = - 0. 459,P = 0. 025),MMEF (r = - 0. 413,P = 0. 031),respectively. Conclusion Serum Cys - C level of patients with AECOPD is significantly elevated, and it changes as disease evolution of COPD,monitoring of serum Cys - C level can effectively evaluate the illness state, treatment outcome and predict the prognosis.
