慢性阻塞性肺疾病患者血浆Clara细胞分泌蛋白水平的变化及其与动脉血气的相关性

摘要 目的：探讨慢阻肺（COPD）患者血浆Clara细胞分泌蛋白（CC16）水平变化及其与动脉血气［动脉血氧酸碱度（pH）、动脉血氧分压（PaO2）、动脉二氧化碳分压（PaCO2）、动脉血氧饱和度（SaO2）］ 的关系。方法：回顾性分析2019年3月~2020年6月本院收治的COPD患者的临床资料，其中COPD稳定期49例，急性加重期45例，并对同一时间段43例健康者的体检资料进行回顾性分析，分别记为A组、B组、C组。对比3组血浆CC16水平；对比3组动脉血气相关参数水平；采用Pearson相关性分析探讨COPD患者稳定期、急性加重期、COPD患者血浆CC16水平变化与动脉血气相关参数的相关性。结果：3组血浆CC16水平对比差异均有统计学意义（P＜0.05），A、B两组血浆CC16水平均明显低于C组（P＜0.05），且B组明显低于A组（P＜0.05）；3组pH、PaO2、SaO2水平对比差异均有统计学意义（P＜0.05），其中A、B两组pH、PaO2、SaO2水平均低于C组（P＜0.05），且B组均明显低于A组（P＜0.05）；A、B两组PaCO2明显高于C组（P＜0.05），且B组明显高于A组（P＜0.05）；COPD患者稳定期、急性加重期、COPD患者血浆CC16水平与pH、PaO2及SaO2水平均呈正相关（稳定期：r=0752、0.824、0.874，急性加重期：r=0.768、0.856、0.917，COPD患者：r=0.759、0.839、0.887，P均＜0.05），与PaCO2则均呈负相关（稳定期：r=-0.819，急性加重期：r=-0.835，COPD患者：r=-0.820，P均＜0.05）。结论：COPD稳定期、急性加重期患者血浆CC16水平与动脉血气相关参数均出现明显变化，且COPD急性加重期患者变化幅度均明显大于COPD稳定期，COPD稳定期、急性加重期患者血浆CC16水平与动脉血气相关参数间均存在相关性。

Changes of plasma Clara cell secretory protein level and its relationship with arterial blood gas in patients with chronic obstructive pulmonary disease

Abstract] Objective: To investigate the changes of plasma Clara cell secretory protein (CC16) and its relationship with arterial blood gas Arterial oxygen pH (pH), arterial partial pressure of oxygen (PaO2), Arterial partial pressure of carbon dioxide (PaCO2), Arterial oxygen saturation (SaO2)] in patients with chronic obstructive pulmonary disease (COPD). Methods: The clinical data of COPD patients admitted to our hospital from March 2019 to June 2020 were retrospectively analyzed, including 49 cases of stable COPD and 45 cases of acute exacerbation. The physical examination data of 43 healthy people in the same period were retrospectively analyzed and recorded as group A, group B and group C respectively. The levels of plasma CC16 were compared among the three groups. The levels of arterial blood gas related parameters were compared among the three groups. Pearson correlation analysis was used to explore the correlation between the changes of plasma CC16 levels and arterial blood gas related parameters in stable and acute exacerbation of COPD patients and total COPD patients. Results: The levels of plasma CC16 in group A and group B were significantly lower than those in group C (P < 0.05), and those in group B were significantly lower than those in group A (P < 0.05). The differences of pH, PaO2 and SaO2 levels among the three groups were statistically significant (P < 0.05). The levels of pH, PaO2 and SaO2 in group A and B were lower than those in group C (P < 0.05), and those in group B were significantly lower than those in group A (P < 0.05). The levels of PaCO2 in group A and B were significantly higher than that in group C (P < 0.05), and that in group B was significantly higher than that in group A (P < 0.05). The levels of plasma CC16 were positively correlated with pH, PaO2 and SaO2 in stable and acute exacerbation of COPD patients and total COPD patients (stable: r = 0752, 0.824, 0.874; acute exacerbation: r = 0.768, 0.856, 0.917; total COPD patients: r = 0.759, 0.839, 0.887, and all Ps < 0.05), but negatively correlated with PaCO2 (stable: r = -0.819, acute exacerbation: r = -0.835; total COPD patients: r = -0.820, and all Ps < 0.05). Conclusion: There were significant changes in plasma CC16 level and arterial blood gas related parameters in patients with stable and acute exacerbation of COPD, and the change range of patients with acute exacerbation of COPD was significantly greater than that of stable COPD. There was a correlation between plasma CC16 level and arterial blood gas related parameters in patients with stable and acute exacerbations of COPD.