CRP和TNF―α在慢阻肺急性加重期病情严重程度判断中意义.docVIP

CRP和TNF―α在慢阻肺急性加重期病情严重程度判断中意义 　　[摘要] 目的 探讨CRP和TNF-α在慢阻肺急性加重期病情严重程度判断中的意义。 方法 选择慢性阻塞性肺疾病急性加重期患者46例，其中21例患者合并呼吸衰竭，为呼吸衰竭组，25例患者不合并呼吸衰竭，为无呼吸衰竭组，另选择健康志愿者30例为对照组，检测各组CRP、TNF-α水平。 结果 治疗前AECOPD患者血清CRP水平和TNF-α水平均显著高于治疗后和对照组（P0.05）。合并呼吸衰竭患者血清CRP水平和TNF-α水平均显著高于未合并呼吸衰竭患者（P0.01）。合并肺心病患者TNF-α水平显著高于未合并肺心病患者（P0.01）。CRP阳性率显著高于WBC阳性率和N%（P0.01）。 结论 CRP和TNF-α可以作为判断AECOPD患者病情严重程度的指标，而CRP 对COPD 急性加重期的判断作用优于WBC以及N%。 　　[关键词] C反应蛋白；肿瘤坏死因子α；慢性阻塞性肺疾病 　　[中图分类号] R563 [文献标识码] A [文章编号] 1673-9701（2015）09-0012-04 　　Significance of CRP and TNF-α in judgment of severity of AECOPD 　　LIANG Weijuan1 HUA Feng2 　　1.Medical College of Ningbo University，Ningbo 315100，China；2.Breath Internal Medicine Department， the Central Hospital of Huzhou City in Zhejiang Province， Huzhou 313000，China 　　[Abstract] Objective To discuss significance of CRP and TNF-α in judgment of severity of AECOPD. Methods Selected 46 cases with AECOPD， 21 cases with respiratory failure was respiratory failure group， 25 cases without respiratory failure was non-respiratory failure group. Thirty healthy volunteers were selected as control group. Serum CRP and TNF-α were detected. Results Pretreatment serum CRP levels and TNF-α levels in patients with AECOPD were significantly higher than after treatment and the control group（P0.05）. Serum CRP and TNF-α levels in patients with respiratory failure were significantly higher than those in patients without respiratory failure（P0.01）. TNF-α level in patients with pulmonary heart disease was significantly higher than that in patients without pulmonary heart disease（P0.01）. CRP-positive rate was significantly higher than the positive rate of WBC and N%（P0.01）. Conclusion CRP and TNF-α in patient with AECOPD are index to determine the severity of illness， and the judgment on the role of CRP in AECOPD is better than WBC and N%. 　　[Key words] CRP； TNF-α； COPD 　　慢性阻塞性肺疾病（chronic obstructive pulmonary disease，COPD）是呼吸内科的常见疾病，COPD的病死率较高，其发病机制与气道以及肺实质、肺血管发生慢性炎症有关[1]。在肺组织中有炎性细胞浸润，而炎性细胞通过释放多种炎性因