Résumé
Objective:To investigate the correlation among serum inflammatory factors, coagulation function and immune function and the condition of elderly patients with chronic obstructive pulmonary disease (COPD).Methods:One hundred and twenty-eight elderly patients with COPD treated in Zhuji Central Hospital from January 2018 to December 2019 were selected and divided into acute attack group (72 cases) and stable group (56 cases) according to the patient′s condition; another 60 elderly healthy people from January 2018 to January 2019 were selected as the control group. The levels of amyloid A (SAA), C-reaction protein (CRP) and procalcitonin (PCT), D-Dimer (D-D), fibrinogen (FIB) and T lymphocyte subsets were compared among the three groups. The percentage of the first second expiratory volume to predicted value (FEV 1%) and the ratio of the first second expiratory volume (FEV 1) and forced vital capacity (FVC) were compared among the three groups. The arterial partial pressure of oxygen (PaO 2) and arterial partial pressure of carbon dioxide (PaCO 2) were compared among the three groups. Results:The levels of serum CRP, SAA and PCT in the acute attack group and stable group were higher than those in the control group and the levels of serum CRP, SAA and PCT in the acute attack group were higher than those in the stable group: (37.29 ± 7.67) mg/L vs. (18.29 ± 3.54) mg/L, (41.32 ± 5.45) mg/L vs. (14.35 ± 3.19) mg/L, (3.87 ± 0.65) ng/L vs. (1.02 ± 0.15) ng/L, the differences were statistically significant ( P<0.05). The serum D-D and FIB levels in the acute attack group and stable group were higher than those in the control group and the serum D-D and FIB levels in the acute attack group were higher than those in the stable group: (3.27 ± 0.36) mg/L vs. (1.08 ± 0.27) mg/L, (3.98 ± 0.56) mg/L vs. (3.07 ± 0.45) mg/L, the differences were statistically significant ( P<0.05). The CD 3+, CD 4+ and CD 4+/CD 8+ levels in the acute attack group and stable group were lower than those in the control group and the CD 3+, CD 4+ and CD 4+/CD 8+ levels in the acute attack group were lower than those in the stable group:0.598 ± 0.062 vs. 0.678 ± 0.046, 0.345 ± 0.032 vs.0.383 ± 0.034, 1.25 ± 0.21 vs. 1.48 ± 0.19, the differences were statistically significant ( P<0.05). The FEV 1% and FEV 1/FVC levels in the acute attack group and stable group were lower than those in the control group and the FEV 1% and FEV 1/FVC levels in the acute attack group were lower than those in the stable group: (43.21 ± 3.65)% vs. (58.98 ± 4.52)%, (42.19 ± 3.25)% vs. (54.38 ± 4.87)%, the differences were statistically significant ( P<0.05). The PaO 2 in the acute attack group and stable group was lower than that in the control group, while PaCO 2 in the acute attack group and stable group was higher than that in the control group, the PaO 2 in the acute attack group was lower than that in the stable group and PaCO 2 in the acute attack group was higher than that in the stable group: (54.53 ± 5.45) mmHg(1 mmHg = 0.133 kPa) vs. (78.71 ± 7.40) mmHg, (68.68 ± 6.54) mmHg vs. (45.23 ± 4.25) mmHg, the differences were statistically significant ( P<0.05). Conclusions:The elderly patients with COPD have obvious inflammatory reaction, abnormal coagulation function and decreased immune function. With the progress of the disease, the inflammatory reaction, abnormal coagulation function and decreased immune function are more obvious.
Résumé
Objective:To comprehensively analyze the clinical values of serum tumor markers of colon cancer, including carbohydrate antigen 724 (CA724), cytokeratin 19 fragment antigen (CYFRA21-1), carbohydrate antigen199 (CA199) and carcinoembryonic antigen (CEA) in the diagnosis and prognosis prediction of colon cancer in patients.Methods:The clinical data of 160 patients with colon cancer who received treatment in Zhuji Central Hospital from January 2018 to December 2020 (observation group) and the clinical data of 156 patients with benign colon polyps who concurrently received physical examination (control group) were retrospectively analyzed. All patients underwent CA724, CYFRA21-1, CA199 and CEA tumor marker screening. The levels of tumor markers, the positive rate of a single tumor marker, and the positive rate of a combination of four markers were compared between the control and observation groups. The levels of tumor markers were compared among different pathological stages. The levels of serum tumor markers were compared among patients with different prognoses based on 1-year follow-up data.Results:CA199-positve rate, CEA-positive rate, CYFRA21-1-positve rate, CA724-positive rate, and the positive rate of a combination of four tumor markers were 85.63% (137/160), 86.88% (139/160), 71.88% (115/160), 85.00% (136/160), and 95.63%(153/160), respectively, which were significantly higher than those in the control group ( χ2 = 8.64, 10.28, 8.33, 9.93, 7.27, all P < 0.001). Serum CA199, CEA, CYFRA21-1 and CA724 levels in patients with stage III-IV colon cancer were (58.96 ± 13.59) U/mL, (38.69 ± 11.84) μg/L, (14.78 ± 3.68) μg/L, (23.68 ± 5.38) U/mL, respectively, which were significantly higher than those in patients with stage I-II colon cancer [(48.35 ± 9.03) U/mL, (23.96 ± 12.25) μg/L, (9.57 ± 2.53) μg/L, (13.02 ± 4.32) U/mL, t = 10.29, 12.02, 8.47, 10.54, all P < 0.001). One-year follow-up results showed that serum levels of CA199, CEA, CYFRA21-1, CA724 in patients with recurrence and metastasis of colon cancer were (38.68 ± 3.04) U/mL, (17.12 ± 4.96) μg/L, (8.94 ± 2.32) μg/L, (11.22 ± 1.94) U/mL, which were significantly higher than those in patients without recurrence of colon cancer [(30.02 ± 2.95) U/mL, (3.75 ± 1.06) μg/L, (3.06 ± 1.15) μg/L, (6.28 ± 1.53) U/mL, t = 8.73, 11.02, 7.72, 7.57, all P < 0.001]. Conclusion:Serum levels of CEA, CA199, CA724 and CYFRA21-1 can be used as important indicators for diagnosis and prognosis prediction of colon cancer.