哮喘鄄COPD重叠综合征机械通气患者肺泡灌洗液SP鄄D及IL鄄8.PDFVIP

袁彬凡等摇 哮喘鄄COPD重叠综合征机械通气患者肺泡灌洗液SP鄄D及IL鄄8意义分析摇 第7期 ·1035 · doi:10.3969/ j.issn.1000鄄484X.2016.07.023 哮喘鄄COPD重叠综合征机械通气患者肺泡灌洗液 SP鄄D 及 IL鄄8 意义 分析 袁彬凡摇 吴摇 东摇 何若云摇 袁亚莲摇 吴摇 斌摇 (广东医科大学附属医院,湛江 524001) 摇 摇 中图分类号摇 R563郾9摇 摇 文献标志码摇 A摇 摇 文章编号摇 1000鄄484X(2016)07鄄1035鄄04 [摘摇 要]摇 目的:观察哮喘鄄COPD 重叠综合征(Asthma鄄 COPD overlap syndrome,ACOS)机械通气患者肺泡灌洗液 (BALF)中肺表面活性物质相关蛋白D(SP鄄D)及白介素鄄8(IL鄄8)的水平,探讨其对ACOS机械通气患者病情发展影响。 方法: 38 例 ACOS机械通气患者根据入院第1天和第5天的APACHE域评分变化,分为病情加重组(18例),及病情缓解组(20例), 收集机械通气1、5 d 的肺泡灌洗液,测定BALF 中SP鄄D、IL鄄8浓度,观察不同预后患者BALF 中SP鄄D、IL鄄8 水平的差异。 结果: 病情缓解组BALF 中SP鄄D含量逐渐上升,机械通气5 d较1d 明显升高(P0郾05);与病情缓解组比较,病情加重组机械通气 1 d、5 dBALF 中SP鄄D含量均明显降低(P0郾05)。 病情缓解组BALF 中IL鄄8含量逐渐下降,病情加重组BALF 中IL鄄8含量逐渐 上升(P0郾05)。 统计分析结果提示BALF 中IL鄄8含量与APACHE II评分呈负相关(r为-0郾44,P0郾05);统计分析结果提示 BALF 中SP鄄D浓度与APACHE II评分也呈负相关(r为-0郾32,P0郾05)。 结论:SP鄄D、IL鄄8在ACOS患者的发生发展中起重要 的作用,BALF 中SP鄄D、IL鄄8可作为ACOS 机械通气患者病情监测和预后的参考指标。 [关键词]摇 ACOS;机械通气;BALF;SP鄄D;IL鄄8 Monitoring and its clinical significance of SP鄄D and interleukin鄄8 levels in bron鄄 choalveolar lavage fluid of ACOS patients undergoing mechanical ventilation YUAN Bin鄄Fan,WU Dong,HE Ruo鄄Yun,YUAN Ya鄄Lian,WU Bin郾Affiliated Hospital of Guangdong Medical University,Zhanjiang 524001,China [Abstract]摇 Objective:To investigate the concentration of pulmonary surfactant鄄associated protein D (SP鄄D) and interleukin鄄8 (IL鄄8)inthebronchoalveolarlavagefluid (BALF)of ACOSpatientsundergoingmechanicalventilation (MV)郾 Methods:38patients with ACOS undergoing MVwereinvolvedinthestudy郾 AccordingtotheAPACHE域score,thepatientsweredividedintotheremission group (n=20) andtheaggravationgroup (n=18)郾BALFwascollectedonthe 1stand5thdaysafter MV郾 Thecontentof IL鄄8andSP鄄 D in BALF was measured by ELISA郾The levels of IL鄄8 and SP鄄D in BALF of the patients with different severity were compared郾 Results:Thelevelof SP鄄Dwassignificantlyhigheronthe5thdaythanonthe1stdayintheremissiongroup,anditdecreasedmoreob鄄 viously in theworsening grou