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目的探讨和肽素与慢性阻塞性肺疾病(COPD)严重程度及预后的关系。方法选取2012年11月—2013年3月在遵义医学院附属医院呼吸一科住院的COPD急性加重期(AECOPD)患者42例,根据COPD综合评估按病情由轻至重分为4组:A组(n=4)、B组(n=12)、C组(n=7)、D组(n=19)。采用双抗体夹心ELISA法检测患者血清和肽素水平,并记录其急性加重期到缓解期所需住院天数。结果 D组患者急性加重期与缓解期血清和肽素水平均高于A、B组,B、C组患者急性加重期与缓解期血清和肽素水平均高于A组(P<0.05);B、C、D组患者缓解期血清和肽素水平均低于急性加重期(P<0.05)。D组患者住院天数长于A、B、C组(P<0.05)。急性加重期患者血清和肽素水平与住院天数呈正相关(r=0.617,P<0.01)。结论和肽素可评价COPD的严重程度,急性加重期血清和肽素水平升高,可导致住院时间延长,提示预后不佳。
Objective To investigate the relationship between copeptin and the severity and prognosis of chronic obstructive pulmonary disease (COPD). Methods Forty-two patients with acute exacerbation of COPD (AECOPD) who were hospitalized in Respiratory Department of Zunyi Medical College Affiliated Hospital from November 2012 to March 2013 were selected and divided into 4 groups according to the severity of COPD: group A (n = 4), group B (n = 12), group C (n = 7) and group D (n = 19). Serum copeptin levels were measured by double-antibody sandwich ELISA and the number of hospitalizations required for acute exacerbation to remission was recorded. Results The levels of serum copeptin in acute exacerbation and remission were significantly higher in group D than those in groups A and B. The levels of serum copeptin in acute exacerbation and remission were significantly higher in group B and group C than those in group A (P <0.05). The levels of serum copeptin in remission group were lower than those in acute exacerbation group (P <0.05) in B, C and D groups. The length of hospital stay in group D was longer than that in groups A, B and C (P <0.05). Serum copeptin levels in patients with acute exacerbations were positively correlated with days of hospitalization (r = 0.617, P <0.01). Conclusion Copeptin can assess the severity of COPD, acute exacerbation of serum copeptin levels, can lead to prolonged hospitalization, suggesting a poor prognosis.