老年慢性阻塞性肺疾病急性发作患者血清中血管内皮因子变化及其意义

目的 探讨老年慢性阻塞性肺疾病急性发作（AECOPD）患者血清中血管内皮因子（VEGF） 在治疗前后血清中的变化.方法 选取2011年10月-2012年10月稳定期慢性阻塞性肺疾病（COPD）患者30例（稳定期COPD组）、急性加重期COPD患者60例（急性加重期COPD组）,其中加重组分为脓痰组30例,非脓痰组30例;同期健康对照者30例（健康对照组）;于入院后24 h内测加重组及稳定组、正常组血管内皮因子（VEGF）、超敏C-反应蛋白（CRP）、白细胞（WBC）、中性粒细胞百分比（N%）及第8天加重组以上各项指标,动态观察各项指标的变化,对病情进行评定.结果 （1）加重组患者第1天血VEGF水平高于稳定组,稳定组高于正常对照组（P〈0.05）;（2）脓痰组第1天VEGF值（233.36±73.98）μg·L-1]明显高于非脓痰组（194.46±65.51）μg·L-1]（P〈0.05）,而His-CRP、WBC、N则无明显变化（P〉0.05）,表明VEGF是慢性阻塞性肺疾病急性加重合并细菌感染的预测指标;（3）脓痰组及非脓痰组VEGF第1天均明显高于第8天,提示VEGF随炎症程度呈动态变化,对疗效监测有一定作用.结论 血清VEGF水平在COPD患者病情急性加重期治疗前后均升高,且其水平随炎症程度呈相应变化,表明VEGF对COPD患者炎症程度判断具有一定指导价值.

Change and significance of vascular endothelial growth factor in the serum of the patients with acute exacerbation of chronic obstructive disease in the elderly

Objective To investigate the chsnge and significance of the vascular endothelial growth factor（VEGF）in serum of the patients with acute exacerbation of chronic obstructive disease （AECOPD） in the elderly. Methods The AECOPD group was further divided into purulent sputhum group（30 cases） and white phlegm group（30 cases） ,as well as another health normal control group with 30 cases. The purulent sputhum group and the normul group were tested by VEGF, serum proculcitoin, high-sensitivity C-reactive protein,white blood cell,neutrophils percentage in 24 hours and the above indicators in the 8th- day infection group,in order to observe dy- namically the change of various inflammatory, indicstors. Results The VEGF in the AECOPD group was higher than thst in the COPD group ,while the VEGF in the COPD group was higher than thst in the normul control group （P 〈 0.05） st the first dsy. VEGF in puru- lent s puthum group was obviously higher than thst in the white phlegm group （P 〈 0.05） ,while the His-CRP,the WBC, N had no sig- nificant change,so VEGF was a good indicstor of diagnosing LRTI in the elderly. VEGF in the purulent sputhum group and the white phlegm group st the first dsy wss higher st the 8^th dsy,which indicsted thst VEGF had the monitor effect on the curstive effect. Conclusions The level of VEGF is higher in the seruna of the AECOPD pstients both before and sfter the trestment snd changes with the patients＇ condition. So it indicstes thst VEGF has certain guiding function for the inflammstion indexes in the AECOPD pstients.