Objective To study the change and clinical value of SP‐D ,CCL18 and CC16 in serum and in exhaled breath con‐densate in acute exacerbation of chronic obstructive pulmonary disease .Methods Sixty two cases of COPD patients admitted in our hospital from 2010 January to 2013 December were selected as the research object .All the 62 patients were divided into group A(32 patients with COPD in acute exacerbation) and group B(30 patients with COPD in remission stage) in accordance with the severity of COPD .Thirty six cases of health people were selected as the control group .Statistical subjects SP‐D ,CCL18 ,CC16 content in se‐rum and in exhaled breath condensate ,and the relations between the various indexes and age ,smoking ,pulmonary function and BMI were analyzed .Results The exhaled breath condensate SP‐D ,CCL18 content in group A was significantly higher than that of B group and the control group (P<0 .05) ,and the SP‐D ,CCL18 in group B was higher than that in control group (P<0 .05) .The se‐rum SP‐D ,CCL18 ,CC16 content in group A was significantly higher than that of B group and the control group (P<0 .05) ,and the SP‐D ,CCL18 ,CC16 in group B was higher than that in control group (P< 0 .05) .Serum SP‐D ,CCL18 levels were significantly higher than those in the exhaled breath condensate (P< 0 .01) .Exhaled breath condensate SP‐D was positively associated with smoking age (r=0 .298 ,P<0 .05) ,and FEV1% pred ,FEV1/FVC (% ) showed a negative correlation (r= -0 .318 ,-0 .402 ,P<0 .05);the serum levels of SP‐D was positively associated with tobacco (r=0 .297 ,P<0 .05) ,and FEV1% pred ,FEV1/FVC (% ) were negative correlated (r= -0 .278 ,-0 .298 ,P<0 .05);serum CC16 and FEV1% pred ,FEV1/FVC (% ) were negatively corre‐lated (r= -0 .358 ,-0 .382 ,P<0 .05);Exhale breath condensate SP‐D ,condensate CCL18 ,SP‐D ,CCL18 serum ,serum CC16 were are positively correlated in each two (P<0 .05);and there was no significant correlation between other indexes and age ,smoking , pulmonary function and BMI etc .Conclusion Exhaled breath condensate ,serum SP‐D ,serum CCL18 ,exhaled breath condensate , exhaled breath condensate ,serum CC16 are closely related to acute exacerbation of COPD ,and monitoring the indicators can be judgment of the degree and prognosis of COPD .%目的：探讨肺表面活性蛋白D（SP‐D）、肺部活化调节趋化因子（CCL18）、Clara细胞蛋白（CC16）在慢性阻塞性肺疾病（COPD）急性加重期血清和呼气冷凝液中的变化及临床价值。方法选择2010年1月至2013年12月被该院收治的COPD患者62例。将62例患者按照COPD严重程度分为COPD急性加重期32例（A组），COPD缓解期30例（B组）。另选择同期在该院体检的健康人群36例为对照组。统计受试者血清和呼气冷凝液中SP‐D、CCL18、CC16水平，并对各指标与年龄、烟龄、肺功能、体质量指数（BMI）的关系进行相关性分析。结果 A组呼气冷凝液 SP‐D、CCL18水平明显高于B组和对照组（P＜0．05），且B组SP‐D、CCL18水平高于对照组（P＜0．05）。A组血清 SP‐D、CCL18、CC16水平明显高于B组和对照组（P＜0．05），且B组SP‐D、CCL18、CC16水平高于对照组（P＜0．05）。血清SP‐D、CCL18水平明显高于呼气冷凝液（P＜0．01）。呼气冷凝液SP‐D与烟龄呈正相关（r＝0．298，P＜0．05），与第1秒用力呼气容积（FEV1％ pred）、1秒率[FEV1／FVC（％）]呈负相关（r＝－0．318、－0．402， P＜0．05）；血清SP‐D与烟龄呈正相关（r＝0．297，P＜0．05），与 FEV1％ pred、FEV1／FVC（％）呈负相关（r＝－0．278、－0．298， P＜0．05）；血清CC16与FEV1％ pred、FEV1／FVC（％）呈负相关（r＝－0．358、－0．382，P＜0．05）；呼气冷凝液SP‐D、CCL18及SP‐D、CCL18、血清CC16之间两两均呈正相关（P＜0．05）；其他指标与年龄、烟龄、肺功能、BMI等因素无相关性。结论呼气冷凝液及血清中SP‐D、CCL18、CC16与COPD急性加重密切相关，监测上述指标可对COPD病情及预后进行监测与判断。
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