CAJ | 학술논문

目的：探讨血清淀粉样蛋白 A （serum amyloid A ，SAA ）水平在慢性阻塞性肺疾病急性加重期（acute exacerbation of chronic obstructive pulmonary disease ，AECOPD）患者中的变化及其临床意义。方法：选择2012年6月—2013年12月收治的AECOPD患者140例和同期就诊的COPD缓解期患者80例及健康对照者40例，检测血清中SAA、C反应蛋白（CRP）、肿瘤坏死因子‐α（TNF‐α）及白细胞介素‐8（IL‐8）水平。结果：与健康体检者比较，COPD患者的血清SAA、TNF‐α、IL‐8、CRP水平均显著升高（P＜0．05），AECOPD组的血清SAA、TNF‐α、IL‐8、CRP水平显著高于COPD缓解组（P＜0．05）；血清SAA与TNF‐α、IL‐8显著相关（r分别为0．78、0．69，P＜0．01），CRP与 TNF‐α、IL‐8也具有显著相关性（r分别为0．68、0．62，P＜0．01）；SAA的ROC曲线下面积（0．841）大于CRP的ROC曲线下面积（0．749），差异具有统计学意义（P＜0．05）。结论：血清SAA有望作为一项新的AECOPD的生物标志物，其血清浓度与疾病的严重程度相关；早期检测SAA的变化有助于判断病情的变化，指导疾病的治疗，值得在临床推广。
목적：탐토혈청정분양단백 A （serum amyloid A ，SAA ）수평재만성조새성폐질병급성가중기（acute exacerbation of chronic obstructive pulmonary disease ，AECOPD）환자중적변화급기림상의의。방법：선택2012년6월—2013년12월수치적AECOPD환자140례화동기취진적COPD완해기환자80례급건강대조자40례，검측혈청중SAA、C반응단백（CRP）、종류배사인자‐α（TNF‐α）급백세포개소‐8（IL‐8）수평。결과：여건강체검자비교，COPD환자적혈청SAA、TNF‐α、IL‐8、CRP수평균현저승고（P＜0．05），AECOPD조적혈청SAA、TNF‐α、IL‐8、CRP수평현저고우COPD완해조（P＜0．05）；혈청SAA여TNF‐α、IL‐8현저상관（r분별위0．78、0．69，P＜0．01），CRP여 TNF‐α、IL‐8야구유현저상관성（r분별위0．68、0．62，P＜0．01）；SAA적ROC곡선하면적（0．841）대우CRP적ROC곡선하면적（0．749），차이구유통계학의의（P＜0．05）。결론：혈청SAA유망작위일항신적AECOPD적생물표지물，기혈청농도여질병적엄중정도상관；조기검측SAA적변화유조우판단병정적변화，지도질병적치료，치득재림상추엄。
Objective:To explore the changes and clinical significance of serum amyloid A (SAA)level in patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD) .Methods:A total of 140 patients with AECOPD ,80 patients with stable stage COPD and 40 health controls during Jun .2012 and Dec .2013 were collected .The serum levels of SAA ,C‐reactive protein(CRP) ,tumor necrosis factor‐α(TNF‐α) and interleukin‐8 (IL‐8) were measured .Results:The serum levels of SAA ,CRP ,TNF‐α and IL‐8 in all patients with COPD were significantly higher than those in the controls (P<0 .05) .The serum levels of SAA ,CRP ,TNF‐α and IL‐8 in patients with AECOPD were significantly higher than those in patients with stable stage COPD(P<005) .SAA level was significantly correlated with TNF‐α level and IL‐8 level(r=0 .78 , r=0 .69 ,P<0 .01) .Serum CRP level was also significantly correlated with TNF‐αlevel and IL‐8 level(r=0 .68 ,r=0 .62 ,P<0 .01) .The area under ROC curve of SAA (0 .841) was larger than that of CRP (0 .749) ,and the difference was statistically significant(P<0 .05) .Conclusions:SAA could be applied as a new biomarker for AECOPD .Its serum level was correlated with the severity of disease .Early detection of SAA may be conducive to the evaluation of disease situation and the treatment strategy for disease .Thus ,it is worthy of clinical application .