中国呼吸与危重监护杂志

中国呼吸与危重监护杂志

慢性阻塞性肺疾病患者血浆前白蛋白、同型半胱氨酸水平及与超敏 C 反应蛋白、体重指数的相关性

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目的探讨慢性阻塞性肺疾病(简称慢阻肺)急性加重期患者在治疗前后血浆前白蛋白(PA)、同型半胱氨酸(Hcy)和超敏 C 反应蛋白(hs-CRP)的变化,分析 PA、Hcy 与 hs-CRP 及体重指数(BMI)的相关性。方法将 GOLD 肺功能为Ⅲ~Ⅳ级的慢阻肺急性加重住院患者 132 例作为试验组,健康体检者 45 例作为对照组。采用全自动生化分析仪测定试验组患者治疗前后及对照组血浆 PA、Hcy 和 hs-CRP 水平,并测定其主要肺功能指标。结果与对照组比较,试验组患者治疗前后血浆 PA 水平明显降低[(146.49±36.53)mg/L 和(219.60±41.29)mg/L 比(269.48±42.63)mg/L],治疗前后血浆 Hcy 水平明显升高[(16.44±5.21)μmol/L 和(12.61±4.56)μmol/L 比(10.13±3.25)μmol/L],治疗前后 hs-CRP 水平明显升高[(45.24±29.94)mg/L 和(7.71±3.41)mg/L 比(5.01±1.52)mg/L](均 P<0.05)。试验组患者治疗后的 PA、Hcy 及 hs-CRP 水平均较治疗前明显好转(均P<0.01)。治疗前后的血浆 PA 值分别与治疗前后 hs-CRP 水平呈负相关(r 值分别为 –0.207 和 –0.199,均 P<0.05),与 BMI 呈显著正相关(r 值分别为 0.573 和 0.550,均 P<0.01)。结论慢阻肺急性加重患者治疗后与治疗前与健康对照者间的血浆 PA、Hcy 及 hs-CRP 水平均有显著差异,PA 与 hs-CRP 呈负相关,与 BMI 呈正相关。检测血浆 PA 及 Hcy 有助于判断慢阻肺患者的病情和疗效,PA 还能在一定程度上反映患者炎症水平及营养状态。

ObjectiveTo explore the changes of plasma prealbumin (PA), homocysteine (Hcy) and high-sensitivity C-reactive protein (hs-CRP) levels before and after treatment in patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD), and analyze the correlation of PA and Hcy with hs-CRP and body mass index (BMI).MethodsA total of 132 hospitalized AECOPD patients with GOLD lung function as grade III-IV were recruited as an experimental group and 45 healthy subjects as a control group. The levels of plasma PA, Hcy and hs-CRP were measured by automatic biochemical analyzer, and the main indexes of pulmonary function were determined in all subjects.ResultsCompared with the control group, the level of plasma PA before and after treatment in the experimental group decreased significantly [(146.49±36.53) mg/L and (219.60±41.29) mg/L vs. (269.48±42.63) mg/L], the level of plasma Hcy before and after treatment increased significantly [(16.44±5.21) μmol/L and (12.61±4.56) μmol /L vs. (10.13±3.25) μmol/L], and the levels of plasma hs-CRP before and after treatment increased significantly [(45.24±29.94) mg/L and (7.71±3.41) mg/L vs. (5.01±1.52) mg/L] (all P<0.05). The levels of plasma PA, Hcy and hs-CRP after treatment were significantly better than before treatment in the experimental group (allP<0.01). The plasma PA values before and after treatment were negatively correlated with the level of hs-CRP before and after treatment, and positively correlated with BMI (bothP<0.05).ConclusionsThe levels of plasma PA, Hcy and hs-CRP are significantly different before and after the treatment in AECOPD patients and the healthy controls. PA is negatively correlated with hs-CRP and positively correlated with BMI. The detection of plasma PA and Hcy can help to determine the condition and efficacy of patients with COPD, and PA can reflect the level of inflammation and nutritional status to a certain extent.

关键词: 慢性阻塞性肺疾病; 前白蛋白; 同型半胱氨酸; 超敏 C 反应蛋白; 体重指数; 相关性分析

Key words: Chronic obstructive pulmonary disease; Prealbumin; Homocysteine; High-sensitivity C-reactive protein; Body mass index; Correlation analysis

引用本文: 聂晓红, 张意, 何瀚夫, 谷琴. 慢性阻塞性肺疾病患者血浆前白蛋白、同型半胱氨酸水平及与超敏 C 反应蛋白、体重指数的相关性. 中国呼吸与危重监护杂志, 2018, 17(4): 331-335. doi: 10.7507/1671-6205.201712026 复制

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