南方医科大学学报

南方医科大学学报 ›› 2016, Vol. 36 ›› Issue (10): 1386-.

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血清糖类抗原125在慢性阻塞性肺疾病急性加重期中的临床意义

张明，李雅莉，杨侠，单虎，张秋红，冯向莉，谢颖颖，唐晶晶，张洁   

  • 出版日期:2016-10-20 发布日期:2016-10-20

Clinical significance of serum carbohydrate antigen 125 in acute exacerbation of chronic obstructive pulmonary disease

  • Online:2016-10-20 Published:2016-10-20

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摘要： 目的探讨糖类抗原125（CA125）在慢性阻塞性肺疾病急性加重期（AECOPD）患者血清中的表达水平及其与肺动脉高压 的关系。方法根据肺功能和心脏彩超结果将研究对象分为3组：AECOPD合并肺动脉高压组（46例）、单纯AECOPD组（46例） 和健康对照组（38例）。收集所有研究对象的临床资料、肺功能和心脏彩超，并测定肺肿瘤标志物全套和脑钠肽（BNP）的血清学 水平。结果与健康对照组相比，AECOPD合并肺动脉高压组、单纯AECOPD组的肺功能显著下降，且AECOPD合并肺动脉高 压组的肺功能最差（P<0.05）。单纯AECOPD组患者的血清CA125较健康对照组显著升高，当合并肺动脉高压时进一步升高 （P<0.05）；而其它肺肿瘤标志物（癌胚抗原、神经元特异性烯醇化酶、非小细胞肺癌相关抗原和胃泌素释放肽前体）在3组之间比 较无统计学差异（P>0.05）。AECOPD合并肺动脉高压组患者的血清BNP水平亦显著高于单纯AECOPD组（P<0.05）。Pearson 直线相关性分析显示，AECOPD合并肺动脉高压组患者的血清CA125与肺动脉收缩压及BNP均呈正相关（P<0.01）。结论血 清CA125可能被用于判断AECOPD是否合并肺动脉高压的一个血清学指标。

Abstract: Objective To study the serum level of carbohydrate antigen 125 (CA125) in patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD) and its relation with pulmonary hypertension. Methods Forty-six patients with AECOPD complicated by pulmonary hypertension, 46 with AECOPD and 38 healthy control subjects were examined for their clinical data, pulmonary function, echocardiographic findings, and serum levels of lung tumor markers and brain natriuretic peptide (BNP). Results Compared with the healthy control group, COPD patients with or without pulmonary hypertension showed significantly decreased pulmonary function (P<0.05), especially in those with AECOPD and concurrent pulmonary hypertension (P<0.05). Serum CA125 level was obviously higher in AECOPD group than in the healthy control group, and further increased in AECOPD patients with pulmonary hypertension (P<0.05). The levels of lung tumor markers (CEA, NSE, CYFRA and PROGRP) were similar among the 3 groups (P>0.05). The serum level of BNP in patients with AECOPD and concurrent pulmonary hypertension was significantly higher than that in patients with AECOPD (P<0.05). Pearson linear correlation analysis showed that serum CA125 was positively correlated with pulmonary artery systolic pressure and BNP in AECOPD patients with pulmonary hypertension (P<0.01). Conclusion Serum CA125 may serve as a serological index to identify AECOPD patients with pulmonary hypertension.