不同体型肥胖与哮喘患者肺功能、气管和全身炎症及病情控制的相关性  

Relationship between type of obesity and lung function, systemic/airway inflammation, and disease control in asthmatic patients

作　　者：陈建辉[1] 徐莉[1] 郑玉龙[1] 顾立志[2] 仇海兵[3] 

机构地区：[1]江苏省淮安市第二人民医院呼吸科,223002 [2]淮安市第一人民医院,223300 [3]淮安市淮阴医院

出　　处：《中华临床营养杂志》2014年第4期209-212,共4页Chinese Journal of Clinical Nutrition

摘　　要：目的 探讨体脂分布在肥胖哮喘发病机制中的地位.方法 招募稳定期哮喘患者125例,并根据体质量指数和腰围分为非肥胖组（n=51）、周围性肥胖组（n=34）和中心性肥胖组（n=40）.分别测定1秒钟用力呼气容积（FEV1）、FEV1占预计值百分比（FEV1％）、用力肺活量（FVC）及FEV1/FVC,检测外周血白细胞介素（IL）-6和超敏C反应蛋白（hs-CRP）浓度,诱导痰嗜酸性粒细胞和中性粒细胞比例,呼出气一氧化氮（NO）浓度,并记录哮喘控制测试（ACT）量表得分.同时采用单因素方差分析和协方差分析[校正吸入糖皮质激素（ICS）剂量]进行统计.结果 中心性肥胖组与非肥胖组FVC[校正ICS平均剂量前（后）]分别为[3.98 （3.99） ±0.99]L和[4.51 （4.51）±1.00]L,外周血IL-6和hs-CRP浓度、诱导痰中性粒细胞比例[校正ICS平均剂量前（后）]分别为[33.63 （33.28）±14.04] ng/L和[21.22 （21.33）±11.23] ng/L,[2.12 （2.15）±0.73] mg/L和[0.92 （0.91） ±0.61] mg/L,52.58 （52.81）±14.14和45.41 （45.34）±12.84,两组比较差异均有统计学意义（均P ＜0.05）;在校正ICS平均剂量后,中心性肥胖患者ACT评分明显低于非肥胖组[（22.10±1.68）分和（23.01±1.62）分],差异有统计学意义（P＜0.05）,周围性肥胖组仅hs-CRP浓度显著高于非肥胖组[（1.54±0.68） mg/L和（0.91±0.61） mg/L],差异有统计学意义（P＜0.05）,其余指标比较差异均无统计学意义（均P＞0.05）.结论 中心性肥胖在肥胖相关哮喘发病机制中起主导作用.Objective To explore the role of body fat distribution in the pathogenesis of obesity-related asthma.Methods Totally 125 patients with stable asthma were recruited and were divided into non-obese group （n =51）,peripheral obesity group （n =34） and central obesity group （n =40） according to body mass index and waist circumference.The FEV1%,FVC,FEV1/FVC ratio,IL-6,and hs-CRP levels in peripheral blood,eosinophil and neutrophil percentage in induced sputum,as well as exhaled NO levels were determined,and asthma control test （ACT） scores were calculated.Both one-way analysis of variance and analysis of covariance were used for statistical analysis.Results The values of FVC in the central obesity group and the non-obese group were [3.98 （3.99） ±0.99] L and [4.51 （4.51） ±1.00] L,while the levels of IL-6 and hs-CRP in peripheral circulation and the percentage of neutrophils in induced sputum were [33.63 （33.28） ± 14.04] ng/L and [21.22 （21.33）±11.23] ng/L,[2.12 （2.15） ±0.73] mg/L and [0.92 （0.91） ±0.61] mg/L,52.58 （52.81） ± 14.14 and 45.41 （45.34） ± 12.84,respectively （all P 〈 0.05）.After adjusting for inhaled corticosteroids （ICS） doses,the ACT scores were also significantly higher in central obesity group （22.10 ± 1.68 vs.23.01 ± 1.62） （P 〈 0.05）.Only the hs-CRP level was found significantly higher in peripheral obesity group than in non-obese group [（1.54±0.68） mg/Lvs.（0.91 ±0.61） mg/L] （P〈0.05）.Conclusion Central obesity may play the leading role in the pathogenesis of obesity-related asthma.

关 键 词：肥胖症 哮喘 中性粒细胞 嗜酸性粒细胞 超敏C反应蛋白 白细胞介素-6 INTERLEUKIN-6 

分 类 号：R589.2[医药卫生—内分泌]