摘要
目的探讨慢性阻塞性肺疾病急性加重期(AECOPD)病人血浆皮质醇(COR)水平变化及其意义。方法选取我院2015年1月—2016年8月收治的131例AECOPD病人作为病例组,另选取同期非AECOPD病人130例作为对照组。根据病情分级情况将病例组病人再分为4个亚组。所有病人入院均行血常规、血生化检查及血气分析,入院次日于6:00、14:00、22:00采集外周静脉血,检测血浆COR水平。结果与对照组相比,病例组病人各时间点血浆COR水平均明显升高(t=2.856～8.849,P<0.05)。病例组各亚组间血浆COR水平比较差异均无显著性(F=1.034～1.739,P>0.05)。Person双变量相关分析显示,病例组病人6:00、14:00、22:00的血浆COR水平与血浆C-反应蛋白(CRP)水平呈正相关性(r=0.294～0.375,P<0.05),与氧分压(PaO2)呈负相关(r=-0.255～-0.243,P<0.05),与二氧化碳分压(PaCO2)呈正相关(r=0.290～0.462,P<0.05)。结论 AECOPD病人血浆COR水平与肾上腺皮质功能相关,COR水平升高病人易出现肾上腺皮质功能紊乱,这对AECOPD病人的临床诊断及治疗具有一定参考意义。
Objective To investigate the change in plasma cortisol(COR)level in patients with acute exacerbation of chronic obstructive pulmonary disease(AECOPD)and its clinical significance.Methods A total of131AECOPD patients who were admitted to our hospital from January2015to August2016were enrolled as case group,and130patients with non-AECOPD were enrolled as control group.According to the grade of conditions,the patients in the case group were further divided into four subgroups.Routine blood test,blood biochemistry,and blood gas analysis were performed for all patients on admission,and peripheral venous blood samples were collected at6:00,14:00,and22:00on the next day after admission to measure the plasma level of COR.Results Compared with the control group,the case group had a significant increase in plasma COR level at each time point(t=2.856-8.849,P<0.05).There was no significant difference in the plasma level of COR between the subgroups of the case group(F=1.034-1.739,P>0.05).The Pearson bivariate correlation analysis showed that the plasma level of COR at6:00,14:00,and22:00was positively correlated with plasma C-reactive protein(r=0.294-0.375,P<0.05),negatively correlated with arterial partial pressure of oxygen(r=-0.255to-0.243,P<0.05),and positively correlated with arterial partial pressure of carbon dioxide(r=0.290-0.462,P<0.05).ConclusionThe plasma level of COR in AECOPD patients is associated the function of adrenal cortex,and patients with elevated COR level tend to develop adrenal cortical dysfunction,which provides a reference for the clinical diagnosis and treatment of AECOPD patients.
作者
王茂泽
石慧芳
陈亚红
王应琼
王秋婷
陈兴峰
Wang Maoze;SHI Huifang;CHEN Yahong;WANG Yingqiong;WANG Qiuting;CHEN Xingfeng(Department of Respiratory Medicine,the Second Affiliated Hospital of Hainan Medical College,Haikou 570311,China)
出处
《青岛大学学报（医学版）》
CAS
2018年第6期703-705,709,共4页
Journal of Qingdao University(Medical Sciences)
基金
海南省自然科学基金项目(科技厅(2012-812172))
关键词
肺疾病
慢性阻塞性
皮质醇
昼夜节律
pulmonary disease,chronic obstructive
cortisol
circadian rhythm
