Abstract: 　Background　Bronchiectasis is a common and frequently-occurring respiratory disease，which is mostly caused by infection.Human secreted phospholipase A2 type X（sPLA2-X）plays an important role in accelerating the occurrence and development of an inflammatory response.However，whether serum sPLA2-X and important inflammatory indicators such as procalcitonin（PCT），C-reactive protein（CRP），inducible nitric oxide synthase（iNOS），and interleukin（IL）-6，IL-17，IL-33，are correlated or not in patients with bronchiectasis and infection，has not been reported.Objective　To study the association of serum sPLA2-X with PCT，CRP，IL-6，iNOS，IL-17 and IL-33 in serum in patients with bronchiectasis and infection，and based on this，to further evaluate its association with this disease.Methods　Participants were enrolled from Guizhou Provincial People's Hospital between February 2017 and January 2019，including 47 with bronchiectasis and infection from Department of Respiratory and Critical Care Medicine（case group），and 21 healthy physical examinees from Physical Examination Center（control group）.Demographic data of the two groups were collected and compared.Also，laboratory findings（such as serum sPLA2-X，white blood cell count，PCT，CRP，iNOS，IL-6，IL-17 and IL-33）of the control group（examined on the day of physical examination）were compared with those of the case group measured before treatment（on the day of admission）and after treatment（on the day prior to discharge），respectively.The association of pre-treatment serum sPLA2-X with PCT，CRP，iNOS，IL-6，IL-17 and IL-33 in the case group was analyzed.Results　Compared with the healthy control group，the mean levels of serum sPLA2-X，PCT，CRP，iNOS，IL-17，white blood cell count，IL-6 and IL-33 in the case group before treatment were all significantly higher（P<0.05），after treatment，although the former five were still much higher（P<0.05），the latter three decreased to the levels similar to those of the controls（P>0.05）.The mean levels of the aforementioned eight indicators decreased significantly in the case group（P<0.05）.Serum sPLA2-X was positively correlated with PCT，CRP，iNOS，IL-6，IL-17，and IL-33 in the case group before treatment（r = 0.526 2，0.640 1，0.550 7，0.516 8，0.609 9，0.357 4，
P<0.01）.Conclusion　In patients with bronchiectasis and infection，serum sPLA2-X is elevated and positively correlated with PCT，CRP，iNOS，IL-6，IL-17，IL-33，indicating that it may be associated with the disease，and might be used as an important indicator for evaluating the severity of the disease.

Key words: Bronchiectasis；Infection；Phospholipases A2, secretory；sPLA2-X；Procalcitonin；C-reactive protein；Inducible nitric oxide synthase；Interleukin

摘要： 背景　支气管扩张症是呼吸系统常见病、多发病，感染是引起支气管扩张症的最常见原因。人分泌型磷脂酶A2-X（sPLA2-X）在炎性反应中发挥重要作用，并可促进炎性反应的发生、发展，而支气管扩张症合并感染患者血清sPLA2-X表达情况及其与重要炎性指标如降钙素原（PCT）、C反应蛋白（CRP）、诱导型一氧化氮合酶（iNOS）、白介素（IL）-6、IL-17、IL-33是否存在相关性尚未见相关报道。目的　研究支气管扩张症合并感染患者血清sPLA2-X表达情况及其与炎性指标——PCT、CRP、iNOS、IL-6、IL-17、IL-33的相关性，并进一步研究血清sPLA2-X对支气管扩张症合并感染的影响。方法　选取2017年2月—2019年1月在贵州省人民医院呼吸与危重症医学科住院治疗的支气管扩张症合并感染患者47例为病例组，选取同期在贵州省人民医院健康体检中心体检的健康志愿者21例为健康对照组。收集研究对象一般资料，分别检测健康对照组体检当天、观察组治疗前（入院当天）与治疗后（出院前1天）血清sPLA2-X、白细胞计数、PCT、CRP、iNOS、IL-6、IL-17、IL-33。比较两组治疗前后观察指标，分析病例组治疗前血清sPLA2-X与PCT、CRP、iNOS、IL-6、IL-17、IL-33的相关性。结果　病例组治疗前血清sPLA2-X、白细胞计数、PCT、CRP、iNOS、IL-6、IL-17、IL-33均高于健康对照组（P<0.05）；病例组治疗后血清sPLA2-X、PCT、CRP、iNOS、IL-17均高于健康对照组（P<0.05）；两组治疗后白细胞计数、IL-6、IL-33比较，差异无统计学意义（P>0.05）。病例组治疗后血清sPLA2-X、白细胞计数、PCT、CRP、iNOS、IL-6、IL-17、IL-33均低于本组治疗前（P<0.05）。病例组治疗前血清sPLA2-X与PCT、CRP、iNOS、IL-6、IL-17、IL-33均呈正相关（r=0.526 2、
0.640 1、0.550 7、0.516 8、0.609 9、0.357 4，P值均<0.01）。结论　支气管扩张症合并感染患者血清sPLA2-X升高，且其与PCT、CRP、iNOS、IL-6、IL-7、IL-33呈正相关，表明血清sPLA2-X与支气管扩张症合并感染有重要的关联，血清sPLA2-X可作为评估支气管扩张症合并感染的参考指标。

关键词: 支气管扩张症, 感染, 磷脂酶A2, 分泌型, 人分泌型磷脂酶A2-X, 降钙素原, C反应蛋白, 诱导型一氧化氮合酶, 白细胞介素