摘要
目的 探讨慢性阻塞性肺疾病急性加重期(AECOPD)患者血清淀粉样蛋白A(SAA)、肿瘤坏死因子-α(TNF-α)、白三烯B4(LTB4)水平的变化及相关性,以提高AECOPD早期诊断率、防范临床误诊的发生.方法 选取2022 年9 月至2023 年12 月收治的AECOPD患者55 例作为观察组,同期选择来院行健康体检的健康者 55 例作为对照组.分析观察组入院时、缓解期和对照组血清SAA、TNF-α、LTB4 水平;治疗前不同严重程度观察组患者血清SAA、TNF-α、LTB4 水平;缓解组和未缓解组血清SAA、TNF-α、LTB4 水平;观察组血清SAA与TNF-α、LTB4 水平的相关性.结果 观察组入院时、缓解期血清 SAA、TNF-α、LTB4 水平显著高于对照组(P<0.05),观察组缓解期血清 SAA、TNF-α、LTB4 水平显著低于观察组入院时(P<0.05).治疗前非呼吸衰竭组血清SAA、TNF-α、LTB4 水平低于呼吸衰竭组(P<0.05).缓解组血清SAA、TNF-α、LTB4 水平显著低于未缓解组(P<0.05).观察组血清SAA与TNF-α、LTB4 水平均呈正相关性(r=0.256、0.482,P<0.05).结论 AECOPD患者血清SAA、TNF-α、LTB4 水平显著升高,并且不同病情程度、治疗效果患者血清SAA、TNF-α、LTB4 水平差异显著,上述指标检测可提高AECOPD诊断率、防范误诊的发生.
Abstract
Objective To investigate the changes in serum amyloid A(SAA),tumor necrosis factor-α(TNF-α)and leukotriene B4(LTB4)levels in patients with acute exacerbation of chronic obstructive pulmonary disease(AECOPD)and their correlation,so as to improve the early diagnosis rate of AECOPD and prevent clinical misdiagnosis.Methods Fifty-five patients with AECOPD admitted to our hospital from September 2022 to December 2023 were selected as the observation group,and 55 healthy patients who presented to our hospital for physical examination during the same period were selected as the control group.The serum levels of SAA,TNF-α,and LTB4 in the observation group at admission,during remission,and in the control group were analyzed,and the serum levels of SAA,TNF-α,and LTB4 in patients of different severity before treatment were recorded.SAA,TNF-α,and LTB4 levels in the remission group and non-remission group,as well as the cor-relation between the serum levels of SAA and TNF-α,and LTB4 in the observation group were observed.Results In the ob-servation group,the serum levels of SAA,TNF-α and LTB4 were significantly higher than those in the control group at admis-sion and during remission(P<0.05),while the serum levels of SAA,TNF-α and LTB4 in remission stage were significantly lower than those at admission(P<0.05).The serum levels of SAA,TNF-α and LTB4 in non-respiratory failure group before treatment were significantly lower than those in respiratory failure group(P<0.05),and the serum levels of SAA,TNF-α and LTB4 in remission group were significantly lower than those in non-remission group(P<0.05).The serum levels of SAA were positively correlated with TNF-α and LTB4 in the observation group(r=0.256,0.482,P<0.05).Conclusion The serum levels of SAA,TNF-α and LTB4 in AECOPD patients are significantly increased,and the serum levels of SAA,TNF-α and LTB4 in AECOPD patients with different disease severity and therapeutic effects are significantly different.Detection of the above indicators can improve the diagnosis rate of AECOPD,and prevent the occurrence of misdiagnosis.