瘦素与慢性阻塞性肺疾病病情严重程度的相关研究  

Research on the relation between leptin and the severity of condition in chronic obstructive pulmonary disease

作　　者：刘玲[1] 付强[1] 况九龙[1] 

机构地区：[1]南昌大学第二附属医院呼吸内科,330006

出　　处：《国际呼吸杂志》2010年第5期257-259,共3页International Journal of Respiration

摘　　要：目的探讨瘦素在慢性阻塞性肺疾病（chronic obstructive pulmonarydisease，COPD）炎症反应和营养不良发生中的作用以及对COPD患者病情严重程度的评估价值。方法选择COPD急性加重期患者40例和健康老年人20名，记录吸烟情况，常规测定肺功能、血常规、血气分析、血清白蛋白（ALB）、身高和体质量，采用ELISA方法测定血清瘦素和白介素6（IL-6）水平，分析COPD急性加重期患者血清瘦素水平与IL-6水平、肺功能、血气指标、营养指标等的相关性，比较急性加重期和症状缓解期、健康对照组血清瘦素、IL-6水平以及吸烟状况、营养状况、病情严重程度不同的患者血清瘦素水平等。结果①COPD患者急性加重期的血清瘦素水平、IL-6水平、白细胞计数（WBC）、中性粒细胞百分比（NEUT％）、动脉血二氧化碳分压（PaCO2）均明显高于症状缓解期和健康对照组，ALB、动脉血氧分压（PaO2）、动脉血氧饱和度（SaO2）则明显低于后者；②COPD患者急性加重期的血清瘦素水平与IL-6水平、WBC、NEUT％、PaCO2呈正相关，与PaO2、SaO2、FEV1占预计值百分比、ALB呈负相关，与FEV1／FVC、BMI、吸烟指数无显著相关性；③营养状况不同组间比较血清瘦素水平无显著差异；④吸烟状况、病情严重程度不同组间比较血清瘦素水平有显著差异。结论瘦素参与了COPD的全身炎症反应过程，可反映COPD患者病情严重程度。Objective To explore the role of leptin in inflammatory reaction and malnutrition in patients with chronic obstructive pulmonary disease （COPD）and the value of leptin on evaluating the severity of condition in patients with COPD. Methods Forty COPD in acute exacerbation and 20 healthy aged people were selected. The smoking informations were recorded. Routinely, the spirometry, arterial blood gas, serum albumin and blood analysis, body height and weight were measured. The serum leptin and interleukin-6 （IL-6）levels were detected by ELISA. The correlation between the serum leptin level and IL- 6 level, lung function, blood gas analysis index, nutrition index,and so on, were analyzed. The serum leptin and IL-6 levels of patients with COPD in acute exacerbation and symptomatic paracmasis and controls were compared. The serum leptin levels of patients with different smoking status, nutritional status, severity of condition,were also compared. Results （1）The serum leptin level, IL-6 level,leucocyte count, percentage of neutrophil, partial pressure of arterial carbon dioxide in patients with COPD in the acute exacerbation were higher significantly than those in symptomatic paracmasis and controls. The serum albumin,partial pressure of arterial oxygen and arterial oxygen saturation were lower significantly than those in symptomatic paracmasis. （2）The serum leptin level in patients with COPD in the acute exacerbation had positive correlation with IL-6 level, leucocyte count, percentage of neutrophil, partial pressure of arterial carbon dioxide, and had negative correlation with partial pressure of arterial oxygen, arterial oxygen saturation, percentage of forced expiratory volume in first second（FEV1 pred）, serum albumin. There were no correlation between the serum leptin level and ratio of FEV1 to forced vital capacity,body mass index,smoking index. （3）There was no difference in the serum leptin levels in groups with different nutritional status. （4）There was significant deviation in the seru

关 键 词：慢性阻塞性肺疾病 瘦素 全身性炎症反应 营养状况 吸烟 

分 类 号：R563.9[医药卫生—呼吸系统]