ABSTRACT
Chronic obstructive pulmonary dia(COPD)is a common chronic respiratory dia with high morbidity and high mortality.The acute pha(AECOPD)repeated episodes is the main reason for progressive decline the lung function and incread mortality in patients with COPD.The high incidence of COPD patients not only brought to life danger and economic burden,but also a rious public health problem to bring a heavy economic burden on society.The nsitive detection indicators of AECOPD and stable pha can make the health workers detect early lesions in patients and change the dosing regimen in time that reduce the injury to the patients with AECOPD,reduce the financial burden on patients and society.To provide theoretical basis for early diagnosis of AECOPD,the experiment explore the changes of antioxidation system level(SOD,GSH,MDA)of the COPD during the treatment(acute period and stable period)significance,At the same time,the joint detection of platelet hematocrit(PCT)level and changes in WBC,and provide a theoretical basis for the early diagnosis of COPD and evaluation of curative effect.
Method:The study lect our80cas of the AECOPD patients(age above40) admitted Respiratory Medicine of our hospital according to<Guide2011revision of diagnosis and treatment of chronic obstructive pulmonary dia>formulate by Chine medical association respiratory neurology.And
lection of30cas of healthy people(age above40)as control group.Control group taken on the morning fasting venous blood of the examination day to detect PCT and WBC with whole blood and detect antioxidant index with rum.COPD patients in hospital take a fasting venous blood in the morning of first day(acute aggravating period),and treatment of5,10,14days(remission)to detect PCT and WBC with whole blood and detect antioxidant index with rum.For each group patients with Pulmonary function tests,temperature measurement,recording changes in sputum volume,dyspnea relief of records,dia progression was obrved in patients.Compare AECOPD and COPD remission of various indicators of change,to explore whether they can be ud to detect COPD acute and remission.Comparing the indicators change and recovery among the patients with all ages,smokers and non-smokers,work environmental exposure to smoke and out of touch with smoke,respectively,to determine the influence of different age,smoking status,work environment with rehabilitation in
patients AECOPD.
情绪测试Results:1.After14days of drug treatment,74AECOPD patients into remission, the dia tends to be stable as the cough and sputum volume decreas.
税率计算
2.Compared with control group,the MPV incread to12.29±1.72fl,the PLT significantly decread to139.46±31.90×109/L(P<0.05),PCT decread to0.130±0.06%;in the white blood cell count showed that the percentage of lymphocytes in the blood of patients was significantly reduced to16.51± 4.68%(P<0.05),the percentage of intermediate cells decread to
3.76± 2.12%,the percentage of neutrophils were significantly incread to91.74±10.87%and total number of leucocytes were incread to13.34±
4.16×109/L(P<0.05);the oxidative stress was induced by infection and inflammation in the body,therefore,lead to patients SOD and GSH levels were significantly reduced to49.13±7.29U/mL and208.16±38.96 mg/L(P<0.05),MDA incread to8.21±1.91nmol/L.After drug treatment into remission,the platelet damage was reduced in COPD patients,platelet MPV tapers to 9.98±2.75fl,PLT and PCT incread to183.21±42.94×109/L and0.185±0.13%, respectively;inflammation has also been effective control,the lymphocyte percentage and the intermediate cells percentage gradually incread to2车辆未年检上路怎么处罚规定
5.43±4.46%and4.12±1.89%,the percentage of neutrophils and leukocytes decread to68.12±4.84%and 9.19±2.86×109/L;the oxidative stress was also decread in the body,SOD and GSH levels were significantly incread to78.59±
6.47U/mL and321.43±4
7.05mg/L (P<0.05),MDA content decread to
8.09±1.63nmol/L.
3.Compare smoking and nonsmoking patients,smoker’s MPV were incread to 12.5±1.9fl,10.0±2.8fl,it was higher than non-smokers,PLT(135.2±50.3×109,17
微观经济学知识点总结4.9±37.4×109)and PCT(0.16±0.08%)were lower than non-smokers,the percentage of neutrophils(99.3±32.5%,88.8±29.6%)and leukocytes(1
5.7±2.8%, 12.5±2.8)higher than non-smoking patients,lymphocyte percentage(15.2±
6.6%, 22.1±0.9%)lower than in non-smokers;SOD and GSH content levels were lower than non-smoking patients,MDA levels(10.8±2.2nmol/L,9.6±2.6nmol/L)was significantly higher than in non-smokers(6.7±1.1nmol/L,5.6±0.2nmol/L)(P <0.05).Contrast the patients who occupational environment exposure to smoke and the patients do not touch the smoke;the platelet analyzes between two types of patient outcomes and white blood cell count was not significant,the antioxidant indicators, MDA levels(12.8±1.0nmol/L)in patients with occupational environment exposure to smoke
were significantly higher than do not exposure to smoke patients(8.2±2.7
怎么冲咖啡nmol/L)(P<0.05).Comparing patients of different ages found that the percentage of lymphocytes(24.1±3.2%)in higher than70years old was lower than the patients with young age,platelet analysis and antioxidant index test results were not significantly different.
Conclusion:1.The expression of Platelets analysis,white blood cell count and antioxidant index of COPD may have some relevance;combined detection of changes of Platelets analysis,white blood cell count and antioxidant index of COPD patients has provided a theoretical basis for the early diagnosis of AECOPD,obrve the condition changes,and evaluation of the therapeutic effectiveness.
2.Smoking have a bad effect on the recovery of COPD acute pha as it can aggravate the damage of platelets，aggravating bacterial infection and inflammation,incread the degree of oxidative stress in vivo;Smoke can aggravate the cellular damage in oxidative stress;Over70ages COPD patients had more rious repeated infection.
Key Words:chronic obstructive pulmonary dia;platelet;white blood cell count;oxidative stress
目录
羊腿
第一部分前言 (1)
第二部分试验方法 (4)
2.1研究对象 (4)
2.1.1对象纳入标准 (4)
分庭抗礼2.1.2对象排除标准 (4)
2.2资料收集 (5)
2.3主要仪器及设备 (5)
日照世帆赛基地2.4主要试剂 (5)
2.5试验方法 (5)
2.6指标观察及测定 (6)
2.6.1肺功能测定 (6)
2.6.2血小板压积的检测 (6)
2.6.3白细胞计数 (6)
2.6.4超氧化物歧化酶的测定 (6)
2.6.5丙二醛的测定 (7)
2.6.6还原型谷胱甘肽的测定 (8)
2.7统计学方法 (8)
第三部分试验结果 (9)
3.1对照组及COPD组患者基本信息 (9)
3.2肺功能测定结果 (9)
3.3血小板压积测定结果 (10)
3.4白细胞计数结果 (12)
3.5抗氧化指标测定结果 (13)
3.6联合检测五项指标敏感性特异性比较 (15)
第四部分讨论 (17)
4.1各组患者基本情况比较 (17)
4.2COPD与肺功能检测及常规观察 (17)
4.3COPD与血小板变化的相关性 (19)
4.4COPD与白细胞数量变化的相关性 (20)
4.5COPD与氧化应激的相关性 (21)
4.6敏感性特异性比较 (22)
4.7吸烟与COPD的相关性 (23)
4.8职业环境与COPD的相关性 (23)
4.9不同年龄段与COPD的相关性 (24)
4.10总结 (24)
第五部分结论与展望 (26)
5.1结论 (26)
5.2下一步工作计划 (26)
附表一 (27)
致谢 (28)
参考文献 (29)
攻读学位期间的研究成果 (32)
综述 (33)
