【摘要】 目的研究观察血清肺表面活性蛋白D（SP-D）、肺表面活性蛋白A（SP-A）与特发性间质性肺纤维化（IPF）患者肺功能、血气指标的相关性以及对预后效果的评估价值探讨。方法方便选取该院2016年1月—2017年12月期间收治的50例IPF患者为研究对象,所有患者均采用相同的治疗方案进行药物治疗,分别于治疗前、治疗后1、3、6个月对患者的血清SP-D、SP-A进行检测,并对患者各时间点的肺功能指标:一氧化碳的弥散量（DLCO）、用力肺活量（FVC）,氧分压（PaO₂）、肺泡动脉血氧分压差（Pa-aO₂）血气指标进行检测。采用Spearman检验对SP-D、SP-A与肺功能、血气功能指标间的相关性进行分析。结果患者治疗前、治疗后6个月的SP-D、SP-A水平分别为（168.92±27.31）、（137.39±26.64）ng/mL,（21.36±5.84）、（16.21±4.22）ng/mL,且随着治疗时间的延长,SP-D、SP-A水平逐步降低,差异有统计学意义（F=37.361、31.769,P<0.05）。相比与治疗前,治疗后患者的DLCO、FVC、PaO₂均有升高,而Pa-aO₂则有降低,且随着治疗时间延长依次改变,差异有统计学意义（F=28.904、27.024、38.284、31.128,P<0.05）。相关性分析显示,SP-D、SP-A与DLCO、FVC、PaO₂呈负相关性,与Pa-aO₂呈正相关性。结论血清SP-D、SP-A与IPF患者肺功能、血气指标间有明显的相关性,在临床上通过对血清SP-D、SP-A的检测有助于判断和评估患者的预后效果,可为IPF患者诊治提供新的简便方法。更多还原

【Abstract】 Objective To investigate the correlation between serum pulmonary surfactant protein D（SP-D）, pulmonary surfactant protein A（SP-A）, and pulmonary function and blood gas parameters in patients with idiopathic interstitial pulmonary fibrosis（IPF）. And the value of the evaluation of the prognosis. Methods A total of 50 patients with IPF who were admitted to the hospital between January 2016 and December 2017 were studied. All patients were treated with the same treatment regimen, before treatment, one month after treatment, and three months after treatment. The serum SP-D and SP-A levels were measured at 6 months after treatment. The lung function parameters at each time point were: carbon monoxide diffusion（DLCO）, forced vital capacity（FVC）, and partial pressure of oxygen（PaO₂）. Oxygenated arterial blood oxygen pressure difference（Pa-aO₂） blood gas index was measured. Spearman test was used to analyze the correlation between SP-D, SP-A and lung function and blood gas function. Results The levels of SP-D and SP-A before and after treatment were（168.92±27.31）,（137.39±26.64） ng/mL,（21.36±5.84）,（16.21±4.22） ng/mL, respectively. With the extension of treatment time, SP-D and SP-A levels gradually decreased,the different was statistically significant（F=37.361, 31.769, P<0.05）. Compared with before and after treatment, DLCO, FVC, and PaO₂ were increased in patients after treatment, but Pa-aO₂ was decreased, and changed in order as treatment time prolonged,the different was statistically significant（F =28.904, 27.024, 38.284, 31.128,P<0.05）. Correlation analysis showed that SP-D and SP-A were negatively correlated with DLCO, FVC, and PaO₂, and positively correlated with Pa-aO₂. Conclusion There is a significant correlation between serum SP-D, SP-A and IPF in patients with pulmonary function and blood gas indexes. Clinically, the detection of serum SP-D, SP-A can help to judge and evaluate the prognosis of patients. It can provide new and easy methods for the diagnosis and treatment of patients with IPF.更多还原