2022 年第 3 期 第 17 卷

血清炎性因子联合检测在慢性阻塞性肺疾病急性加重期患者病情评估中的临床应用价值

Clinical value of combined detection of serum inflammatory factors in the evaluation of patients with acute exacerbation of chronic obstructive pulmonary disease

作者：黄颖骏秦斌斌沈斌朱佳嫣郑琪郑兴东胡婧玮宋雅君

英文作者：Huang Yingjun Qin Binbin Shen Bin Zhu Jiayan Zheng Qi Zheng Xingdong Hu Jingwei Song Yajun

单位：上海交通大学医学院附属第九人民医院黄浦分院呼吸内科，上海200011

英文单位：Department of Respiratory Huangpu Branch of Shanghai Ninth People′s Hospital Shanghai Jiao Tong University School of Medicine Shanghai 200011 China

关键词：慢性阻塞性肺疾病；白细胞介素6；降钙素原；B型脑钠肽；D-二聚体

英文关键词：Chronicobstructivepulmonarydisease;Interleukin-6;Procalcitonin;Brainnatriureticpeptide;D-dimer

• 摘要：

• 目的 探讨血清白细胞介素6(IL-6)、降钙素原、B型脑钠肽(BNP)、D-二聚体及C反应蛋白(CRP)水平联合检测在慢性阻塞性肺疾病急性加重期（AECOPD）患者病情评估中的临床应用价值。方法  回顾性选取2019年7月至2021年7月上海交通大学医学院附属第九人民医院黄浦分院收治的93例AECOPD患者作为研究对象(AECOPD组)，并根据疾病严重程度分为轻度AECOPD组（30例）和中重度AECOPD组（63例）。另选取同期体检健康成年人91例作为正常对照组。比较各组受试者血清IL-6、降钙素原、BNP、D-二聚体及CRP水平，各组数据均取自然对数底以符合正态分布。结果 AECOPD组IL-6、降钙素原、BNP及D-二聚体水平均明显高于正常对照组［（2.2±0.7）ng/L比（1.6±0.5）ng/L、（-2.2±1.1）ng/L比（-2.6±0.8）ng/L、（4.4±1.3）ng/L比（3.8±1.0）ng/L、（-0.4±0.9）mg/L比（-0.7±0.7）mg/L］，差异均有统计学意义（均P＜0.05）。2组CRP水平比较差异无统计学意义（P=0.473）。中重度AECOPD组IL-6、降钙素原、BNP及D-二聚体水平均明显高于正常对照组，而轻度AECOPD组仅IL-6水平明显高于正常对照组（均P＜0.05）。结论  IL-6、降钙素原、BNP、D-二聚体均能在一定程度上反映AECOPD患者病情严重程度。炎性因子联合检测有助于全面了解患者所处疾病状态，做出准确评估及诊断。

• Objective   To investigate the clinical value of combined detection of serum interleukin-6 (IL-6), procalcitonin (PCT), brain natriuretic peptide (BNP), D-dimer and C-reactive protein (CRP) in evaluating patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD). Methods   From July 2019 to July 2021, 93 patients with AECOPD admitted to Huangpu Branch of Shanghai Ninth People′s Hospital, Shanghai Jiao Tong University School of Medicine were selected as the research object (AECOPD group) retrospectively. According to the severity of the disease, they were divided into mild AECOPD group (30 cases) and moderate and severe AECOPD group (63 cases). Ninety-one healthy adults who underwent physical examination were selected as the normal control group. Serum levels of IL-6, PCT, BNP, D-dimer and CRP were compared among the groups. The data of each group were taken from the natural logarithm base to conform to the normal distribution. Results  The levels of IL-6, PCT, BNP and D-dimer in the AECOPD groups were significantly higher than those in the normal control group［（2.2±0.7）ng/L vs （1.6±0.5）ng/L, （-2.2±1.1）ng/L vs （-2.6±0.8）ng/L, （4.4±1.3）ng/L vs （3.8±1.0）ng/L, （-0.4±0.9）mg/L vs （-0.7±0.7）mg/L］(all P＜0.05). There was no significant difference in the level of CRP between the two groups (P=0.473). The levels of IL-6, PCT, BNP and D-dimer in the moderate and severe AECOPD group were significantly higher than those in the normal control group, while the level of IL-6 in the mild AECOPD group was significantly higher than that in the normal control group only (all P＜0.05). Conclusions IL-6, PCT, BNP and D-dimer can reflect the severity of AECOPD to a certain extent. The combined detection of inflammatory factors is helpful to fully understand the disease status of patients and to make accurate evaluation and diagnosis.