慢性阻塞性肺疾病患者血浆晚期糖基化终末产物和可溶性糖基化终末产物受体浓度变化及其临床意义  

Variation of Plasma Advanced Glycation End Products and Soluble Receptor for Advanced Glycation End Products and Its Significance in COPD Patients

作　　者：雷超[1] 胡占升[2] 

机构地区：[1]辽宁医学院研究生院,辽宁省锦州市121000 [2]辽宁医学院附属第一医院重症医学科

出　　处：《中国全科医学》2014年第8期875-879,共5页Chinese General Practice

基　　金：辽宁省教育厅科学技术研究项目(2008419)

摘　　要：目的观察慢性阻塞性肺疾病(COPD)患者血浆晚期糖基化终末产物(AGEs)和可溶性糖基化终末产物受体(sRAGE)变化,探讨其临床意义。方法选取2012年5月—2013年5月辽宁医学院附属第一医院重症监护病房收治的患者共102例,其中COPD患者53例为COPD组,非COPD患者49例为非COPD组;根据呼吸功能检测结果将COPD患者分为4个亚组,即轻度COPD组15例、中度COPD组13例、重度COPD组15例以及极重度COPD组10例。采用酶联免疫吸附试验测定所有患者血浆AGEs和sRAGE浓度。结果 COPD组患者血浆AGEs浓度为(35.45±3.30)μg/ml,高于非COPD组的(29.62±0.83)μg/ml(P<0.001)。COPD组患者血浆sRAGE浓度为(330.15±112.11)pg/ml,低于非COPD组的(884.53±190.94)pg/ml(P<0.001)。极重度COPD组血浆AGEs浓度高于重度COPD组,重度COPD组高于中度COPD组,中度COPD组高于轻度COPD组,差异均有统计学意义(P<0.01);4个亚组COPD患者血浆sRAGE浓度比较,差异无统计学意义(F=2.71,P=0.84)。直线相关分析结果显示,COPD患者血浆AGEs浓度与一秒用力呼气容积占预计值百分比(FEV1%)呈负相关(r=-0.90,P<0.05);血浆sRAGE浓度与FEV1%无直线相关关系(r=0.270,P>0.05)。结论血浆AGEs浓度升高可能是COPD的危险因素,而血浆sRAGE浓度降低可能是COPD的保护因素,血浆AGEs浓度可以作为判断COPD患者病情严重程度的指标,血浆AGEs浓度升高预示COPD患者预后不良。Objective To discuss the changes of the plasma advanced glycation end products（AGEs）and soluble receptor for advanced glycation end products（sRAGE）in patients with chronic obstructive pulmonary disease（COPD）and its clinical significance.Methods From May 2012 to May 2013,a total of 102 patients were divided,according to the diagnostic criteria of COPD,into groups non-COPD（n=49）,COPD（n=53）,and group COPD divided,according to the results of respiratory function test,into subgroups mild（n=15）,moderate（n=13）,severe（n=15）,very severe（n=10）.Enzyme-linked immunosorbent assay（ELISA）was used to determine the levels of AGEs,sRAGE.Results The level of AGEs was higher in COPD group[（35.45±3.30）μg/ml]than in non-COPD group[（29.62±0.83）μg/ml]（P＜0.001）,and the level of sRAGE lower[（330.15±112.11）pg/ml,（884.53±190.94）pg/ml,respectively,P＜0.001].The level of AGEs was higher in very severe subgroup than in severe subgroup,in severe subgroup than moderate subgroup,in moderate subgroup than in mild subgroup,the difference was significant（P＜0.01）.No difference was noted in sRAGE level in 4 subgroups（F=2.71,P=0.84）.By results of linear correlation analysis,AGEs level was negatively correlated with 1 sec forced expiratory volume （FEV1%）（r=-0.90,P＜0.05）,there was no linearly correlation between sRAGE and FEV1%（r=0.270,P＞0.05）.Conclusion Increased AGEs level may be a risk factor of COPD,decreased sRAGE level be a protective factor.AGEs level can be an indicator judging severity of COPD,increased AGEs level suggests poor prognosis.

关 键 词：糖基化终产物 高级 可溶性糖基化终末产物受体 肺疾病 慢性阻塞性 

分 类 号：R563[医药卫生—呼吸系统]