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目的:通过监测不同病期患者血浆中同型半胱氨酸(homocysteine,HCY)水平的变化,探讨其在慢性阻塞性肺疾病(chronic obstructive pulmonary disease,COPD)病情监测、预后评价、预防的临床意义。方法:2006年1月至2009年12月,以本院住院的COPD急性发作期患者103例作为急性发作期组,72例COPD临床缓解期患者为缓解期组,68例健康体检者作为对照组采用酶联免疫吸附法检测3组受检者血浆中HCY的水平变化,同时检测受检者的动脉血气、吸烟指数、体质量指数、肺功能、心脏彩色多普勒等,并对结果进行分析比较。结果:COPD急性发作期和临床缓解期HCY含量显著高于正常对照组[(37.43±25.69)μmol/L,(24.56±8.98)μmol/L,(11.28±1.95)μmol/LP<0.01]。COPD急性发作期HCY含量显著高于临床缓解期(P<0.01),合并肺心病的COPD急性发作期患者HCY含量显著高于未合并肺心病患者(P<0.01)。结论:COPD患者存在高同型半胱氨酸血症,血浆HCY参与了COPD的病理生理过程,通过监测HCY,可以反映COPD的病情变化,对预测COPD的高危状态有一定的参考价值。
OBJECTIVE: To investigate the clinical significance of homocysteine (HCY) in patients with chronic obstructive pulmonary disease (COPD) monitoring, prognosis evaluation and prevention by monitoring the changes of plasma homocysteine (HCY) . Methods: From January 2006 to December 2009, 103 acute exacerbation COPD patients hospitalized in our hospital were treated as acute exacerbation group, 72 patients with remission of COPD were remission stage, and 68 healthy people as control group The levels of HCY in plasma were detected by enzyme-linked immunosorbent assay (ELISA), and arterial blood gas, smoking index, body mass index, lung function and cardiac color Doppler were detected at the same time, and the results were analyzed Compare Results: The HCY levels in acute exacerbation and remission of COPD were significantly higher than those in control group [(37.43 ± 25.69) μmol / L, (24.56 ± 8.98) μmol / L, (11.28 ± 1.95) μmol / L0.01]. The HCY content of acute exacerbation of COPD was significantly higher than that of clinical remission (P <0.01). The HCY content of COPD patients with acute exacerbation of COPD was significantly higher than that of patients without pulmonary heart disease (P <0.01). CONCLUSIONS: Hyperhomocysteinemia exists in COPD patients, and plasma HCY participates in the pathophysiological process of COPD. HCY monitoring can reflect the changes of COPD and provide some reference value for predicting COPD high-risk status.