慢性阻塞性肺疾病急性加重期患者血清胱抑素C水平变化及其临床意义

慢性阻塞性肺疾病急性加重期患者血清胱抑素C水平变化及

其临床意义

王会卿;尹刚;刘军霞;刘才锐

【期刊名称】《实用心脑肺血管病杂志》

【年(卷),期】2015(000)009

【摘要】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。%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.【总页数】4页(P33-36)

【作者】王会卿;尹刚;刘军霞;刘才锐

【作者单位】073000 河北省定州市妇幼保健院呼吸科;073000 河北省定州市妇幼保健院呼吸科;073000 河北省定州市妇幼保健院儿科;073000 河北省定州市妇幼保健院呼吸科

【正文语种】中文

【中图分类】R563.9