慢性阻塞性肺疾病与代谢综合征及颈动脉内膜厚度的相关性研究  

A Study on the Correlations of Metabolic Syndrome, Carotid Intima-media Thickness with Chronic Obstructive Pulmonary Disease

作　　者：周春艳[1] 尹相风 孙吉 戚群燕 雷涛[3] 

机构地区：[1]同济大学医学院,上海200092 [2]上海市普陀区长征镇社区卫生服务中心,上海200333 [3]上海市同济医院,同济大学附属同济医院,上海200065

出　　处：《现代生物医学进展》2016年第10期1825-1828,共4页Progress in Modern Biomedicine

基　　金：上海市卫生局科研基金项目(20124256)

摘　　要：目的:研究慢性阻塞性肺疾病与代谢综合征及颈动脉内膜厚度的关系。方法:选择2014年8月至2015年4月在我院就诊的慢性阻塞性肺疾病患者60例作为研究组,另选择同期在我院接受健康体检的60名志愿者作为对照组。比较两组空腹血糖、甘油三酯及高密度脂蛋白胆固醇水平、代谢综合征的发生率、颈动脉内膜厚度以及合并与不合并代谢综合征的慢性阻塞性肺疾病患者的肺功能和颈动脉内膜厚度,并采用多元回归分析颈动脉内膜厚度与慢性阻塞性肺疾病及代谢综合征的相关性。结果:与对照组相比,研究组患者空腹血糖(FPG)明显升高,而甘油三酯(TG)水平明显降低,差异具有统计学意义(P<0.05);两组高密度脂蛋白胆固醇(HDL-C)比较差异无统计学意义(P>0.05)。研究组代谢综合征的发病率、颈动脉内膜厚度均明显高于对照组,差异具有统计学意义(P<0.05);慢性阻塞性肺疾病合并代谢综合征患者的肺功能明显优于无代谢综合征的慢性阻塞性肺疾病患者,差异具有统计学意义(P<0.05);合并代谢综合征的慢性阻塞性肺疾病患者FEV1占预计值百分比及FEV1/FVC均明显高于无代谢综合征慢性阻塞性肺疾病患者的对应值,差异具有统计学意义(P<0.05)。Logistic回归分析结果显示慢性阻塞性肺疾病与颈动脉内膜厚度呈独立相关性,而代谢综合征与颈动脉内膜厚度无直接相关性。结论:慢性阻塞性肺疾病与颈动脉内膜厚度呈独立相关,且慢性阻塞性肺疾病合并代谢综合征患者发生颈动脉粥样硬化的风险更高。Objective： To study the relationship between metabolic syndrome（MS）, chronic obstructive pulmonary disease（COPD）and intima-media thickness（IMT）. Methods： 60 patients with COPD who were treated in our hospital from August 2014 to April 2015 were selected as the study group, and 60 volunteers who received health examination in our hospital were selected as the control group.Then the FBG, triglyceride and high density lipoprotein cholesterol level, the incidence of metabolic syndrome, carotid intima media thickness and pulmonary function of COPD patients with or without metabolic syndrome were observed and compared. And the relationship of carotid artery intima thickness and chronic obstructive pulmonary disease and metabolic syndrome was analyzed by the multiple regression analysis. Results： Compared with control group, the FPG obviously increased and the TG decreased in the study group（P〈0.05）; There was no statistically significant difference in the HDL-C between the two groups（P〉0.05）; The incidence of metabolic syndrome and IMT in the study group were higher than those of the control group（P〈0.05）; The pulmonary function of COPD patients with MS was better than that of the COPD patients without MS（P〈0.05）; The FEV1 and FEV1/FVC of patients with COPD and MS were significantly higher than those of the COPD patients without MS（P〈0.05）. Logistic regression analysis showed that carotid IMT were independently associated with COPD but had no siginificant correlation with MS. Conclusion： The risk of carotid atherosclerosis in patients with COPD complicated with MS was higher, but the specific mechanism still needed further study.

关 键 词：慢性阻塞性肺疾病 代谢综合征 颈动脉内膜厚度 

分 类 号：R589[医药卫生—内分泌] R563[医药卫生—内科学]