Perincek Gökhan, Avcı Sema
Kars Harakani State Hospital.
Acta Biomed. 2018 Oct 16;90(1):37-43. doi: 10.23750/abm.v90i1.6780.
Chronic obstructive pulmonary disease (COPD) is a disease that causes obstructed air flow from the lungs. The disease also has a dramatic role in increasing rate of mortality and morbidity in recent years. Air pollution, long-term exposure to particulate matter and irritating gases, especially cigarette smoke, genetic inheritance which has an impact on the initial forced expiratory volume one in second (FEV1), and alpha-1-antitrypsin (AAT) deficiency are among common COPD risk factors. The objective of this study is to evaluate parameters and serum AAT levels in COPD patients.
Having taken the approval of local ethical committee, this cross-sectional study was performed with adult patients diagnosed with COPD, whose serum AAT levels were measured through nephelometric analysis in Kars Harakani State Hospital where secondary health care is served. The study evaluated ATT levels in patients' serum in relation to their age, gender, body mass (BMI), exposure to cigarette smoke, FEV1 percentage, hospitalization in pulmonology or intensive care unit through a year, mortality status, white blood cell (WBC), c-reactive protein (CRP) and blood gases.
The average age of the 243 patients included in the study was 68.41±11.52 and 160 (65.8%) of them were male. The age and BMI of the female patients were higher. Of the all patients only a single patient's serum AAT level was below the reference value. AAT levels were similar in both genders irrespective of their being exposed to cigarette smoke or being discharged or being exitus at their first admission to hospital, being exitus in the first year of disease diagnose, and being hospitalized in intensive care unit. AAT levels were reasonably correlated with WBC and CRP in a positive way (p<0.001 r=0.289 for WBC; p<0.001, r=0.295 for CRP). AAT levels were seen to significantly increase along with COPD stages which go up with FEV1 percentages (p<0.001). CRP was watched to have increased to Stage III COPD (severe COPD). However, it was watched to have decreased in Stage IV (very severe COPD) (p =0.179).
In the study, AAT serum levels of COPD patients were examined. The levels and their relations in various parameters of the patients were evaluated.
慢性阻塞性肺疾病（COPD）是一种导致肺部气流受阻的疾病。近年来，该疾病在死亡率和发病率上升方面也起着显著作用。空气污染、长期接触颗粒物和刺激性气体，尤其是香烟烟雾、对初始一秒用力呼气量（FEV1）有影响的遗传因素以及α-1抗胰蛋白酶（AAT）缺乏都是常见的COPD危险因素。本研究的目的是评估COPD患者的各项参数和血清AAT水平。
在获得当地伦理委员会批准后，本横断面研究对诊断为COPD的成年患者进行，这些患者的血清AAT水平在提供二级医疗服务的卡尔斯哈拉克尼州立医院通过比浊法进行测量。该研究评估了患者血清中AAT水平与他们的年龄、性别、体重指数（BMI）、接触香烟烟雾情况、FEV1百分比、一年内因肺部疾病或重症监护病房住院情况、死亡率、白细胞（WBC）、C反应蛋白（CRP）和血气之间的关系。
纳入研究的243例患者的平均年龄为68.41±11.52岁，其中160例（65.8%）为男性。女性患者的年龄和BMI较高。在所有患者中，只有1例患者的血清AAT水平低于参考值。无论患者是否接触香烟烟雾、首次入院时是否出院或死亡、疾病诊断后第一年是否死亡以及是否入住重症监护病房，男女患者的AAT水平相似。AAT水平与WBC和CRP呈正相关（WBC：p<0.001，r=0.289；CRP：p<0.001，r=0.295）。随着COPD阶段的升高，AAT水平显著升高，而COPD阶段随FEV1百分比升高（p<0.001）。观察到CRP在COPD III期（重度COPD）时升高。然而，在IV期（极重度COPD）时观察到CRP下降（p =0.179）。
在本研究中，对COPD患者的血清AAT水平进行了检测。评估了患者各项参数中AAT水平及其相互关系。
