血清维生素D3水平与慢性阻塞性肺疾病及肺功能的相关性  

The Relationship between Serum Level of 1,25(OH)_2D_3 and COPD and Pulmonary Function

作　　者：王永生[1] 刘洪[1] 李群英[1] 张弛[1] 李惠华[1] 

机构地区：[1]成都市第一人民医院呼吸内科,四川成都610041

出　　处：《四川医学》2016年第11期1276-1279,共4页Sichuan Medical Journal

摘　　要：目的检测慢性阻塞性肺疾病(COPD)患者外周血维生素D主要代谢产物1,25-(OH)_2维生素D3水平,分析其与COPD患者及其肺功能的相关性,探讨血清1,25-(OH)_2维生素D3缺乏对COPD的影响。方法收集COPD急性加重期患者66例,健康人60例。所有受试者均检测外周血1,25-(OH)_2维生素D3水平,然后测量各组肺功能。比较两组血清1,25-(OH)_2维生素D3水平,比较两组肺功能指标(FEV_1%预计值,FEV_1/FVC%)有无差异性。将COPD组分为Ⅱ级、Ⅲ级、Ⅳ级,比较各级间1,25-(OH)_2维生素D3水平有无差异性,并分析1,25-(OH)_2维生素D3与COPD疾病严重程度肺功能指标的相关性。结果 COPD组患者的血清1,25-(OH)_2维生素D3水平(37.53±15.34)ng/m L明显低于健康对照组(67.23±15.74)ng/m L,差异有统计学意义(P<0.01)。COPD组患者肺功能指标(FEV_1%预计值,FEV_1/FVC%)均明显低于健康对照组,差异有统计学意义(P<0.01)。66例COPD组患者根据GOLD分级分为Ⅱ级(21例)、Ⅲ级(22例)、Ⅳ级(23例),血清1,25-(OH)_2维生素D3水平随着GOLD分级增加而降低,差异有统计学意义(P<0.01)。COPD组血清1,25-(OH)_2维生素D3水平与FEV_1%预计值呈正相关(r=0.620,P<0.01),与FEV_1/FVC(%)呈正相关(r=0.318,P<0.05)。结论 COPD患者的血清1,25-(OH)_2维生素D3水平明显低于健康普通人群,血清维生素D水平影响肺功能,并与COPD的严重程度、肺功能下降呈正相关关系,提示COPD患者应补充维生素D及钙剂。Objective To detect a serum level of 1,25（ OH）2D3,which is a major metabolite of vitamin D in Chronic obstructive pulmonary disease（ COPD） patients and analyze its relationship with COPD patients and pulmonary function,and explore the effects of lacking 1,25（ OH）2D3 on COPD. Methods 66 patients with acute exacerbation and 60 healthy people were collected.All cases were received detection of serum levels of 1,25（ OH）2D3,and pulmonary function in each group was measured.Serum level of 1,25（ OH）2D3 and lung function index（ forced expiratory volume in1 second percent predicted,FEV1%,FEV1/ FVC%）of each group were compared.The COPD group was divided into gradeⅡ,Ⅲ,Ⅳ and serum levels of 1,25（ OH）2D3 in each grade were compared and the correlation of 1,25（ OH）2D3 and severity of COPD and lung function indexes were analyzed.Results The serum levels of 1,25（ OH）2D3 of COPD group（ 37. 53±15. 34） ng / m L were significantly lower than that of healthy group（ 67. 23±15. 74） ng / m L）,and the difference was statistically significant（ P〈0. 01）.According to Gold Grade,66 COPD patients were divided into gradeⅡ（ 21 cases）,Ⅲ（ 22 cases）,Ⅳ（ 23 cases）. Serum levels of 1,25（ OH）2D3 decreased while grade GOLD was increasing（ P〈0. 01）.There was a positive correlation between serum levels of 1,25（ OH）2D3 and FEV1%（ r = 0. 620,P〈 0. 01） as well as FEV1/ FVC（ %）（ r = 0. 318,P〈 0. 05） in COPD group. Conclusion The serum levels of 1,25（ OH）2D3 of COPD patients were significantly lower than that of healthy group. The serum level of 1,25（ OH）2D3 influences lung function,and has a positive correlation with severity of COPD and lung function decreasing.

关 键 词：慢性阻塞性肺疾病 维生素D 1 25-(OH)2维生素D3 肺功能指标 

分 类 号：R563.9[医药卫生—呼吸系统]