摘要
目的通过检测不同程度急性肺损伤（ALI）/急性呼吸窘迫综合征（ARDS）患者血清及支气管肺泡灌洗液（BALF）中中性粒细胞弹性蛋白酶（NE），探讨其对评价肺损伤严重程度和预后的临床指导意义。方法将36例ALI／ARDS患者按氧合指数进行分组：A组氧合指数为201-300mmHg（1mmHg=0.133kPa），19例；B组为150-200mmHg，10例；C组为〈150mmHg，7例。并选取健康对照者16例（对照组），各组均进行血清及BALF中NE测定。结果A、B、c三组患者血清和BALF中NE分别为（1．76±0．63）nmol／L和（1．67±0．59）nmol／L、（3．26±0．51）nmol／L和（3．64±0．56）nmol／L、（4．56±0．68）nmol／L和（4．62±0．39）nmol／L，均明显高于对照组[（0．67±0．54）nmol／L和（0．62±0．48）nmol／L]，差异均有统计学意义；死亡组患者血清及BALF中NE明显高于存活组（P〈0．01），而且ALUARDS患者的血清NE与氧合指数呈显著负相关性（r=-0．901，P〈0．01）。结论ALI／ARDS患者血清和BALF中NE明显升高，其水平与患者的肺损伤严重程度和预后密切相关。
Objective To investigate the neutrophil elastase （NE） in patients with acute lung injury （ALI） /acute respiratory distress syndrome （ARDS）. Methods Thirty-six patients of ALI/ ARDS and 16 healthy volunteers（control group）were involved in the study. The patients of ALI/ ARDS were divided in-to three groups：group A （the oxygenation index was 201-300 mm Hg,1 mm Hg = 0.133 kPa）, group B （150-200 mm Hg）,and group C （ 〈 150 mm Hg）. The NE in serum and bmnchoalveolar lavage fluid （BALF） were measured. Results The NE in the serum and BALF in group A [（1.76±0.63）nmol/L and （1.67±0.59 ）nmol/L], group B [ （3.26±0.51 ）nmol/L and （3.64±0.56）nmol/L] and group C [ （4.56±0.68 ）nmol/L and （4.62±0.39 ）nmol/L ] were much higher than that in control group [ （0.67±0.54）nmol/L and （0.62±0.48）nmol/L]. The NE in the serum and BALF of dead patients were higher than that in patients who were alive. Moreover, the NE in the patients of ALl / ARDS was inversely related to the oxygenation index （r = -0.901 ,P 〈 0.01 ）. Conclusion The NE in patients of ALI/ ARDS is higher than that in healthy people, and it is significantly related to the severity and the prognosis of ALI/ ARDS.
出处
《中国医师进修杂志（内科版）》
2008年第4期41-43,共3页
Chinese Journal of Postgraduates of Medicine
