AECOPD 期血清胆红素水平变化的临床研究

摘要

Objective:To observe the clinical significance of the serum bilirubin differences in acute ex-acerbation of chronic obstructive pulmonary disease (AECOPD) , patients in stable phase and healthy con-trol.Method:60 AECOPD patients admitted in our hospital as observation group , 60 patients with COPD in stable phase were as control group A , 60 healthy control in the same period were as control group B , with Hitachi 7170 A full-automatic biochemical detector and Japan Chestac-8800 pulmonary function detector to test the three groups of serum total bilirubin ( TBIL) and direct bilirubin ( IBIL) levels and pulmonary func-tion, at the simultaneous analysed the correlation among TBIL , IBIL and the pulmonary function .Result:①TBIL and IBIL level of the observation group and control group A were lower than control group B ( P<0. 05), TBIL and IBIL level of observation group were lower than control group A (P<0.05).② pulmonary function FEV1%, FEV1 /FVC of the two groups of patients with COPD were significantly weaker than con-trol group B (P<0.01), compared with control group A, the decrease of pulmonary function in observation group was more obvious .③ Linear correlation analysis indicated that COPD patients serum bilirubin level and FEV1.0, FEV1 /FVC, FEV1%were negative correlation .Conclusion:The serum bilirubin is associ-ated with progression of COPD , lower the serum bilirubin concentration of AECOPD can ease the illness .%目的：观察血清胆红素在慢性阻塞性肺疾病急性加重期（AECOPD）、稳定期患者及健康体检者的表达差异及临床意义。方法：将本院收治的60例AECOPD患者设为观察组，60例COPD稳定期患者设为对照A组，同期60例健康体检者设为对照B组，分别采用日立7170 A全自动生化检测仪和日本捷斯特产 Chestac－8800型肺功能仪检测三组人员的血清总胆红素（ TBIL ）和直接胆红素（ IBIL）水平及肺功能，同时分析TBIL、IBIL 与肺功能之间的相关性。结果：①观察组和对照A 组的TBIL及IBIL水平均较对照B组升降低（P 均＜0．05），其中观察组TBIL及IBIL水平均低于对照A组（P均＜0．05）。②两组COPD患者的肺功能FEV1％，FEV1／FVC明显弱于对照B组（P均＜0．01），其中与对照A组相比，观察组肺功能下降的幅度更为明显。③经过直线相关分析后可知：COPD患者血清胆红素水平与FEV1．0，FEV1／FVC，FEV1％均呈正相关关系。结论：血清胆红素可能成为防止COPD病情发展的关键靶点，适当的上调AECOPD血清胆红素的浓度可达到缓和病情的目的。