血清TNF-α、hs-CRP和PA检测在老年慢性阻塞性肺疾病中的临床价值

摘要

目的 探讨血清肿瘤坏死因子α(TNF-α),高敏C反应蛋白(hs-CRP)和前白蛋白(PA)在老年慢性阻塞性肺疾病(COPD)诊疗中的临床意义. 方法 分别检测58例COPD急性加重期患者和24例缓解期患者血清TNF-α、hs-CRP和PA水平,并与同期50例体检健康者比较. 结果 TNF-α和hs-CRP水平在COPD急性加重期较缓解期明显增高,急性加重期和缓解期TNF-α和hs-CRP水平较对照组明显增高(P＜0.01).而PA水平急性加重期和缓解期低于对照组,急性加重期水平低于缓解期(P＜0.01).随着肺功能下降,TNF-α和hs-CRP水平也逐渐增高(P＜0.01)；而相反,PA水平则逐渐降低(P＜0.01). 结论 TNF-α、hs-CRP和PA表达水平与疾病严重程度相关,可能参与了COPD气道炎症反应,检测三者可作为判断COPD临床分期、气流受限程度的指标.%Objective To study the serum levels of tumor necrosis factor-a (TNF-a) , high-sensitivity C reactive protein( hs-CRP)and prealbumin (PA) in patients with chronic obstructive pulmonary disease ( COPD) in different stages. Methods 58 patients with acute exacerbation of COPD, 24 patients in remission stage and 50 healthy persons in the same period were detected for serum levels of TNF-a,hs-CRP and PA. Results Serum levels of TNF-a and hs-CRP in patients with acute exacerbation of COPD were significantly higher than those in remission stage of COPD, and serum levels of TNF-a and hs-CRP in remission stage or acute exacerbation of COPD were significantly higher than those of healthy persons (P < 0. 01). Serum level of PA in acute exacerbation or remission stage of COPD was lower than that of healthy persons, while the level of PA in acute exacerbation of COPD was lower than that of patients in remission stage of COPD (P < 0. 01). With the improvement of lung function, the serum levels of TNF-a and hs-CRP were gradually increased(P < 0. 01 ) ; in contrast, with the improvement of lung function,the level of PA was gradually reduced(P <0. 01). Conclusions TNF-a,hs-CRP and PA are involved in airway inflammation of COPD, and there is relationship between their expression levels and the severity of disease, hence combined detection of these three makers can be used as indices of clinical stage and degree of airflow limitation in patients with COPD.