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目的 探讨严重急性呼吸综合征 (SARS)的肺纤维化程度与血清纤维化指标透明质酸(HA)、Ⅲ型前胶原氨端肽 (PⅢNP)的关系。方法 用放免法动态测定我院 2 0 0 3年 2～ 5月收治的 5 6例SARS患者血清HA、PⅢNP。同时结合临床特点 ,胸部X光片 ,病理切片等 ,分析上述血清学指标水平与肺组织纤维化之间的关系。结果 SARS重症患者急性期、恢复期以及痊愈等不同时期 ,血清HA、PⅢNP水平均不同程度高于对照组 (P <0 .0 1) ,并且与一些炎症指标呈正相关关系。SARS轻症患者急性期血清HA与对照组有显著性差异 (P <0 .0 1) ,而恢复期及随访血清HA与对照组均无显著性差异 ,SARS轻症患者各期血清PⅢNP与对照组均无显著性差异。结论 对血清中HA、PⅢNP水平同时测定 ,可有助于SARS患者肺纤维化的诊断、活动性的观察及研究肺纤维化的发病机理。
Objective To investigate the relationship between the degree of pulmonary fibrosis in severe acute respiratory syndrome (SARS) and the serum levels of hyaluronic acid (HA) and type Ⅲ procollagen Aminopeptidase (PⅢNP). Methods The serum levels of HA and PⅢNP in 56 SARS patients admitted to our hospital from February to May in 2003 were determined by radioimmunoassay. Combined with clinical features, chest X-ray, pathological sections, etc., the level of serum markers and the relationship between lung fibrosis. Results The levels of serum HA and PⅢNP were significantly higher in patients with severe acute respiratory syndrome (SARS) at acute, convalescent and recovering stages than those in the control group (P <0.01), and positively correlated with some inflammatory markers. Serum HA in acute SARS patients was significantly different from that in control group (P <0.01), but there was no significant difference between convalescent and follow-up serum HA and controls (P> 0.05) There was no significant difference between groups. Conclusions Simultaneous determination of HA and PⅢNP in serum can be helpful for the diagnosis and activity of pulmonary fibrosis in SARS patients and the pathogenesis of pulmonary fibrosis.