慢性阻塞性肺疾病合并睡眠呼吸暂停综合征老年患者肺部感染气道炎性损伤及血清SAA CRP水平变化意义

doi:10.3969/j.issn.1006-6233.2024.04.07

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摘要 目的: 探讨慢性阻塞性肺疾病(COPD)合并睡眠呼吸暂停综合征(OSAS)老年患者肺部感染、气道炎性损伤及血清淀粉样蛋白A(SAA)、C-反应蛋白(CRP)水平变化的意义。方法: 选择2021年1月至2023年6月我院收治的120例老年COPD合并OSAS患者纳入COPD合并OSAS组,另选取本院同期收治的120例老年COPD患者纳入单纯COPD组。比较COPD合并OSAS组和单纯COPD组肺部感染检出率、血清IL-6、IL-10、IL-1β、COX-2和CRP、SAA水平;比较肺部感染和未感染患者血清指标水平;ROC分析血清CRP、SAA水平对COPD合并OSAS患者肺部感染的评估效能。结果: COPD合并OSAS组肺部感染检出率为28.33%,高于单纯COPD组的17.50%(P<0.05);COPD合并OSAS组血清IL-6、IL-10、IL-1β、COX-2和血清CRP、SAA水平均高于单纯COPD组(P<0.05);肺部感染COPD合并OSAS患者血清CRP、SAA水平均显著高于未感染患者(P<0.05);ROC分析显示,血清CRP、SAA 评估老年COPD合并OSAS患者肺部感染的AUC分别为0.834、0.894,联合检测评估肺部感染的AUC为0.929(P<0.05)。结论: 老年COPD合并OSAS患者血清CRP、SAA和气道炎性损伤指标水平呈现异常升高趋势,血清CRP、SAA联合检测对老年COPD合并OSAS患者肺部感染具有最佳评估效能。

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关键词 ：慢性阻塞性肺疾病, 老年, 睡眠呼吸暂停综合征, 肺部感染, 气道炎性损伤, 淀粉样蛋白A

Abstract：Objective: To explore pulmonary infection, airway inflammatory injury, changes significance of serum amyloid A (SAA) and C-reactive protein (CRP) in elderly patients with chronic obstructive pulmonary disease (COPD) and obstructive sleep apnea syndrome (OSAS). Methods: A total of 120 elderly patients with COPD and OSAS and 120 elderly patients only with COPD in the hospital were enrolled as COPD combined OSAS group and simple COPD group between January 2021and June 2023. The detection rate of pulmonary infection and levels of serum IL-6, IL-10, IL-1β, COX-2, CRP and SAA were compared between the two groups. The levels of serum indexes in patients with pulmonary infection and those without infection were compared. The evaluation efficiency of serum CRP and SAA for pulmonary infection was analyzed by ROC curves. Results: The detection rate of pulmonary infection in COPD combined OSAS group was higher than that in simple COPD group (28.33% vs 17.50%, P<0.05), and levels of serum IL-6, IL-10, IL-1β, COX-2, CRP and SAA were also higher than those in simple COPD group (P<0.05). The levels of serum CRP and SAA in patients with pulmonary infection were significantly higher than those in patients without infection (P<0.05). ROC curves analysis showed that AUC values of serum CRP, SAA and combined detection for evaluating pulmonary infection were 0.834, 0.894 and 0.929, respectively (P<0.05). Conclusion: The levels of serum CRP, SAA and airway inflammatory injury indexes are abnormally increased in elderly patients with COPD and OSAS. The combined detection of serum CRP and SAA has the best evaluation efficiency for pulmonary infection.

Key words： Chronic obstructive pulmonary disease Elderly Obstructive sleep apnea syndrome Pulmonary infection Airway inflammatory injury Serum amyloid A

基金资助:安徽省重点研究与开发计划项目,(编号:202004j07020017)

引用本文:

付晓培, 时靖峰, 腾小宝, 韩明锋, 曹冠亚, 解明然. 慢性阻塞性肺疾病合并睡眠呼吸暂停综合征老年患者肺部感染气道炎性损伤及血清SAA CRP水平变化意义[J]. 河北医学, 2024, 30(4): 564-569.
FU Xiaopei, SHI Jingfeng, TENG Xiaobao, et al. Pulmonary Infection Airway Inflammatory Injury Changes Significance of Serum SAA and CRP in Elderly Patients with COPD and Obstructive Sleep Apnea Syndrome. HeBei Med, 2024, 30(4): 564-569.

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http://www.hbyxzzs.cn/CN/10.3969/j.issn.1006-6233.2024.04.07 或 http://www.hbyxzzs.cn/CN/Y2024/V30/I4/564

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