AECOPD 血清胆红素水平变化的临床意义

摘要

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（根据机械通气标准分为ICU治疗组28例及内科治疗组32例），60例COPD稳定期患者设为对照组，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）、直接胆红素（ DBIL）和间接胆红素（ IBIL）水平及肺功能，同时分析TBIL、DBIL、IBIL与肺功能之间的相关性。结果：观察组的TBIL、DBIL、及IBIL水平均较对照组降低（ P均＜0．05），其中ICU治疗组降低的趋势较内科治疗组明显（P＜0．05）；观察组的肺功能FEV1％，FEV1／FVC明显弱于对照组（P 均＜0．01），其中ICU治疗组降低的趋势较内科治疗组明显（P＜0．05）；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：血清胆红素水平是反应机体氧化／抗氧化失衡的敏感指标，反应疾病的发展程度，同时抗氧化治疗可能是预防和控制AECOPD病情发展的重要措施之一。%Objective:To observe the serum bilirubin differences between acute exacerbation of chronic obstructive pulmonary disease ( AECOPD ) , and the patients in stable phase , and the clinical significance . Method:Set 60 AECOPD patients admitted in our hospital as observation group ( According to the standard of ICU mechanical ventilation , divided into 28 cases of ICU treatment group and 32 cases of medical treat-ment group), 60 patients with COPD in stable phase were set as control group , with Hitachi 7170 A full-au-tomatic biochemical detector and Japan Chestac-8800 pulmonary function detector to test the three groups of serum total bilirubin ( TBIL) ,direct bilirubin ( DBIL) and direct bilirubin ( IBIL) levels and pulmonary func-tion, at the simultaneous analysed the correlation between TBIL , IBIL and the pulmonary function .Result:TBIL and IBIL level of the observation group were lower than control group ( P<0.05) , the reducing trend of ICU treatment group were evident than control group (P<0.05).The pulmonary function FEV1 %, FEV1/FVC of the observation group were significantly weaker than control group ( P<0.01) , compared with medi-cal treatment group , the reduce trend of pulmonary function in ICU treatment group was more obvious .Linear correlation analysis indicated that COPD patients serum bilirubin level and FEV 1.0 , FEV1 /FVC, FEV1%were negative correlation .Conclusion: The serum bilirubin level is a sensitive indicator to reactive oxida-tion/antioxidant imbalance in the body , reflects the development degree of the disease , and antioxidant treat-ment may be one of the important measures of prevention and control of progression of disease of AECOPD .