血清炎性标志物对老年慢性阻塞性肺疾病的临床诊断价值研究

目的探讨血清和肽素、IL-6和CRP等分子标志物在慢性阻塞性肺疾病(COPD)急性加重期(AECOPD)的水平变化，观察其与COPD急性加重期临床关系。方法收集陕西省人民医院呼吸内二科住院AECOPD老年患者102例，应用ELISA法及乳胶比浊法检测血清和肽素、IL-6和CRP等分子生物标志的血清表达水平变化，与正常患者及患者组间比较，观察各个指标与患者急性加重程度和临床分期之间的关系。结果在AECOPD患者中，疾病治疗前后，其血清中和肽素、IL-6和CRP水平分别为2.68±2.14 pmol/L，1.02±0.60 pmol/L;73.22±28.62 μg/ml，14.64±8.49 μg/ml，47.64±15.48 mg/L，10.57±6.56 mg/L，显著高于健康对照组(1.01±0.46 pmol/L，6.21±4.20 μg/ml，5.14±3.72 mg/L)，组间比较t值分别为2.96，5.71和4.95，差异有统计学意义(P＜0.05)；治疗后，经AECOPD患者自身对照发现治疗后血清和肽素、IL-6和CRP水平显著低于治疗前患者，配对检验t值分别为3.02，8.20和9.33，组间差异有统计学意义(P＜0.05)。结论血清和肽素、IL-6和CRP等分子标志物可作为判断AECOPD疾病病程，及在治疗过程中感染被控制的客观指标，对正确判断COPD患者急性加重期的病情具有重要的临床价值。

Study on the Value of Three Serum Biomarkers for Diagnosis Elderly Patients with Chronic Obstructive Pulmonary Disease

ObjectiveTo understand the serum copeptin，interleukin-6(IL-6)，C-reactive protein (CRP) levels assess their clinical significance in acute exacerbation of chronic obstructive pulmonary disease patients (AECOPD)．Methods86 patients with acute exacerbation of obstructive pulmonary disease were enrolled into the study．At the same time were 50 healthy persons were taken as normal control group，ELISA method for detecting of serum copeptin，IL-6 and CRP level．ResultsSerum copeptin，IL-6 and CRP levels were significantly higher than the healthy control group，and the value were 2.68±2.14 pmol/L，1.02±0.60 pmol/L；73.22±28.62 μg/ml，14.64±8.49 μg/ml and 47.64±15.48 mg/L，10.57±6.56 mg/L，respectively．There was significant difference (1.01±0.46 pmol/L，6.21±4.20 μg/ml，5.14±3.72 mg/L)(t=2.96，P<0.05) in these groups．In acute stage of chronic pulmonary disease，the serum copeptin，IL-6 and CRP levels increased distinctly，after given therapies，and the serum copeptin，IL-6 and CRP levels decreased (P＜0.05)．ConclusionSerum copeptin，IL-6 and CRP levels has important clinical value for judging the severity of AECOPD and the severity of systemic inflammatory response caused by COPD．