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-  2015 

慢性阻塞性肺疾病急性加重患者血清和呼出气冷凝液中肺表面活性蛋白D与趋化因子配体18的表达及其临床意义

DOI: doi:10.7507/1671-6205.2015052

Keywords: 慢性阻塞性肺疾病, 肺表面活性蛋白D, 趋化因子配体18, 呼出气冷凝液

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Abstract:

目的探索肺表面活性蛋白D (SP-D)、趋化因子配体18(CCL18)表达在慢性阻塞性肺疾病(简称慢阻肺)急性加重患者病情监测中的意义。 方法选取2012年4月至2013年4月慢阻肺急性加重患者22例(慢阻肺急性加重组),健康吸烟者22例(对照组)。记录研究对象的年龄、烟龄、体重指数(BMI)、肺功能检查结果。收集慢阻肺急性加重组治疗前、后及对照组的血清和呼出气冷凝液(EBC),采用酶联免疫吸附试验(ELISA)检测各研究对象血清和EBC中SP-D、CCL18表达。分析SP-D、CCL18表达与年龄、烟龄、BMI及肺功能的相关性。 结果与对照组比较,慢阻肺急性加重组患者治疗前血清及EBC中SP-D表达明显升高[(353.1±221.7) ng/mL比(207.3±171.6) ng/mL,(2.6±1.1) ng/mL比(1.9±1.1) ng/mL,P<0.05],而治疗后血清及EBC中SP-D表达比较,差异无统计学意义(P>0.05)。慢阻肺急性加重组治疗前后血清和EBC中SP-D表达比较,差异无统计学意义(P>0.05)。与对照组比较,慢阻肺急性加重组治疗前EBC中CCL18表达显著降低[(14.2±5.2) pg/mL比(19.1±5.6) pg/mL,P<0.05)],而治疗后EBC中CCL18表达差异无统计学意义(P>0.05);慢阻肺急性加重组治疗前EBC中CCL18表达低于治疗后[(14.2±5.2) pg/mL比(19.4±7.0) pg/mL,P<0.05]。各组研究对象血清中CCL18表达比较,差异均无统计学意义(P>0.05)。相关性分析结果表明:血清中SP-D表达与烟龄正相关(r=0.34,P<0.05);与第1秒用力呼气容积(FEV1)、FEV1占预计值百分比(FEV1% pred)、用力肺活量(FVC)、FEV1与FVC比值(FEV1/FVC)负相关(r分别为-0.35、-0.34、-0.31、-0.36,P<0.05);与年龄、BMI均不相关(P>0.05)。EBC中SP-D表达与烟龄正相关(r=0.11,P<0.05);与FEV1/FVC负相关(r=-0.37,P<0.05);与年龄、BMI、FEV1、FEV1% pred、FVC均不相关(P>0.05)。血清和EBC中CCL18表达和年龄、烟龄、BMI、FEV1、FEV1% pred、FVC及FEV1/FVC均不相关(P>0.05)。 结论EBC和血清中SP-D、CCL18表达变化在慢阻肺急性加重病情监测中具有一定价值,而且EBC中SP-D、CCL18表达变化在慢阻肺急性加重患者病情监测中更具独特的优势

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