目的：：观察哮喘-COPD 重叠综合征( Asthma- COPD overlap syndrome, ACOS )机械通气患者肺泡灌洗液(BALF)中肺表面活性物质相关蛋白D(SP-D)及白介素-8(IL-8)的水平,探讨其对ACOS机械通气患者病情发展影响。方法：38例 ACOS机械通气患者根据入院第1天和第5天的APACHEⅡ评分变化,分为病情加重组(18例),及病情缓解组(20例),收集机械通气1、5 d的肺泡灌洗液,测定BALF中SP-D、IL-8浓度,观察不同预后患者BALF中SP-D、IL-8水平的差异。结果：病情缓解组BALF中SP-D含量逐渐上升,机械通气5 d较1 d明显升高(P<0.05)；与病情缓解组比较,病情加重组机械通气1 d、5 d BALF中SP-D含量均明显降低(P<0.05)。病情缓解组BALF中IL-8含量逐渐下降,病情加重组BALF中IL-8含量逐渐上升(P<0.05)。统计分析结果提示BALF 中IL-8含量与APACHE II评分呈负相关(r为-0.44,P<0.05)；统计分析结果提示BALF中SP-D浓度与APACHE II评分也呈负相关(r为-0.32,P<0.05)。结论：SP-D、IL-8在ACOS患者的发生发展中起重要的作用,BALF中SP-D、IL-8可作为ACOS 机械通气患者病情监测和预后的参考指标。%Objective:To investigate the concentration of pulmonary surfactant-associated protein D ( SP-D) and interleukin-8 (IL-8) in the bronchoalveolar lavage fluid (BALF) of ACOS patients undergoing mechanical ventilation (MV). Methods:38 patients with ACOS undergoing MV were involved in the study. According to the APACHEⅡscore, the patients were divided into the remission group (n=20) and the aggravation group (n=18). BALF was collected on the 1st and 5th days after MV. The content of IL-8 and SP-D in BALF was measured by ELISA. The levels of IL-8 and SP-D in BALF of the patients with different severity were compared. Results:The level of SP-D was significantly higher on the 5th day than on the 1st day in the remission group,and it decreased more ob-viously in the worsening group (P<0. 05). The level of IL-8 decreased gradually in the remission group but increased gradually in the worsening group. The level of SP-D was negatively correlated with IL-8 level and APACHEⅡ score. Conclusion:The findings suggest that the levels of SP-D and IL-8 in BALF are correlated with prognosis of ACOS patients undergoing MV,and it may prove to be useful as a guidance of therapy and prognosis.
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