【摘要】 目的观察CPY2A6基因多态性在频繁急性加重型COPD（AECOPD）患者中的临床特点。方法采用前瞻性队列研究设计。选择2016年4月～2019年4月在我院接受治疗的AECOPD患者,通过检测患者血浆CYP2A6基因型将患者分组为CYP2A6野生型组和CYP2A6缺失型（变异型）。最终133例患者入组,包括CYP2A6野生型108例,CYP2A6缺失型25例。CYP2A6基因检测采用限制性片段长度多态性聚合酶链反应进行。结果 CYP2A6野生型组在吸烟例数、急诊入院例数多于缺失型（P<0.001）。频繁加重后入院次数、死亡率、住院时间、APECHEⅡ评分、当日机械通气和肾替代治疗例数以及伴随疾病在两组间没有统计学差异（P>0.05）。CYP2A6野生型组的血气分析结果波动幅度较大,缺失型患者具有更低PaO₂、更高的PaCO₂和HCO₃^-、高肌酐血症,心率变化幅度较大,与CYP2A6缺失型比较,差异有统计学意义（均P<0.05）。结论 CYP2A6野生型患者在频繁急性加重COPD患者中可能有更紊乱的血气生化指标和生理变化,同时有更高的吸烟率,更多以急诊形式入院。更多还原

【Abstract】 Objective To observe the characteristics of CPY2 A6 gene polymorphism in patients with acute exacerbations of chronic obstructive pulmonary disorder（AECOPD）. Methods This is a prospective cohort study. Patients with AECOPD who were treated in our hospital from April 2016 to April 2019 were divided into CYP2A6 wild type group and CYP2A6 deletion（or variant）type group by detecting CYP2A6 genotype. Finally,133 patients were enrolled,including 108 cases of CYP2A6 wild type and 25 cases of CYP2A6 deletion type. CYP2A6 gene was detected by real-time PCR combined with the restriction enzyme fragment length polymorphism analysis. Results In the CYP2A6 wild type group,the number of smoking cases and emergency admission cases was more than that of the CYP2A6 deletion type group（P<0.001）. There was no significant difference between the two groups in the number of admission in a year,mortality,length of stay,APACHE Ⅱ score,the number of cases of mechanical ventilation,renal replacement therapy on the first day,and comorbidities（P>0.05）.CYP2A6 wild-type group greatly fluctuated biochemical indexes of blood gas analysis. The patients with CYP2A6 wild-type had lower PaO₂,higher PaCO2_,HCO₃^-,hypercreatinine,and larger heart rate changes when compared those with CYP2A6 deletion type（P<0.05）. Conclusion CYP2A6 wild-type patients may have more disordered blood gas biochemical indexes and physiological changes in AECOPD.Meanwhile,the patients with smoking history in CYP2A6 wild-type group are more than CYP2A6 deletion type group,and the type of admission is more urgent hospitalization in CYP2A6 deletion type groups.更多还原