慢性阻塞性肺疾病急性加重期患者血脂水平与PCT IL-6和CRP含量的相关性研究  

Correlation between serum lipid levels and PCT,IL-6 and CRP levels in patients with acute exacerbation of chronic obstructive pulmonary disease

作　　者：李方方 袁晓雨 张铁栓[2] LI Fang-fang;YUAN Xiao-yu;ZHANG Tie-shuan(The Second Clinical Medical College of Zhengzhou University, Henan 450000, China)

机构地区：[1]郑州大学第二临床学院,河南450000 [2]郑州大学第二附属医院呼吸内科,河南450014

出　　处：《中国临床新医学》2020年第3期280-284,共5页CHINESE JOURNAL OF NEW CLINICAL MEDICINE

摘　　要：目的研究慢性阻塞性肺疾病急性加重期(AECOPD)患者的血脂水平与炎症因子的相关性。方法选择2018-03~2019-03住院治疗的AECOPD患者152例,根据有无呼吸衰竭分为呼吸衰竭组62例和非呼吸衰竭组90例。呼吸衰竭组均为Ⅱ型呼吸衰竭。检测两组患者的总胆固醇(TC)、甘油三酯(TG)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)、降钙素原(PCT)、白介素-6(IL-6)、C反应蛋白(CRP)、动脉血氧分压(PaO 2)、动脉血二氧化碳分压(PaCO 2)、第1秒用力呼气容积占预计值百分比(FEV1/pred)和第1秒用力呼气容积/用力肺活量(FEV1/FVC)相关指标并对比分析。采用Pearson相关性分析分析患者炎症因子、血脂水平与血气、肺功能指标相关性以及血脂水平与炎症因子的相关性。结果呼吸衰竭组血清炎症因子PCT、IL-6、CRP、血气指标PaCO 2水平均显著高于非呼吸衰竭组,差异有统计学意义(P<0.01);呼吸衰竭组血脂水平TC、TG、HDL-C、血气指标PaO 2、肺功能指标FEV1/pred、FEV1/FVC均显著低于非呼吸衰竭组,差异有统计学意义(P<0.01),两组LDL-C差异无统计学意义(P>0.05)。Pearson相关性分析结果显示,AECOPD患者PCT、IL-6、CRP与PaO 2、FEV1/pred、FEV1/FVC呈显著负相关性(P<0.001),与PaCO 2呈显著正相关性(P<0.001);血脂TC、TG、HDL-C与PaO 2、FEV1/pred、FEV1/FVC呈正相关性(P<0.05),与PaCO 2呈负相关性(P<0.05)。LDL-C与PaO 2、PaCO 2、FEV1/pred、FEV1/FVC相关性很低(P>0.05);TC、TG、HDL-C与PCT、IL-6、CRP均呈显著负相关性(P<0.001),LDL-C与PCT、IL-6、CRP相关性很低(P>0.05)。结论AECOPD患者炎症因子明显升高,血脂TC、TG、HDL-C水平明显降低,血脂水平与炎性因子呈负相关性,提示两者水平变化可反映患者病情严重程度。Objective To study the correlation between serum lipid levels and inflammatory factors in patients with acute exacerbation of chronic obstructive pulmonary disease(AECOPD).Methods A total of 152 inpatients with AECOPD were selected from March 2018 to March 2019.According to whether there was respiratory failure or not,the patients were divided into two groups:62 cases in respiratory failure group and 90 cases in non-respiratory failure group.The patients in the respiratory failure group had typeⅡrespiratory failure.The relevant indicators of the patients were detected and compared between the two groups,including total cholesterol(TC),triglyceride(TG),high-density lipoprotein(HDL-C),low-density lipoprotein(LDL-C),procalcitonin(PCT),interleukin-6(IL-6),C-reactive protein(CRP),arterial partial pressure of oxygen(PaO2),arterial partial pressure of carbon dioxide(PaCO2),forced expiratory volume in 1 second as a percentage of predicted value(FEV1/pred)and forced expiratory volume/forced vital capacity(FEV1/FVC)in the first second.Pearson correlation analysis was used to analyze the correlation between inflammatory factors,serum lipid levels and blood gas,lung function indicators,and the correlation between serum lipid levels and inflammatory factors.Results The levels of serum inflammatory factors of PCT,IL-6 and CRP,and blood gas index PaCO2 in the respiratory failure group were significantly higher than those in the non-respiratory failure group(P<0.01).The serum lipid levels of TC,TG and HDL-C,blood gas index PaO2,lung function indexes FEV1/pred and FEV1/FVC in the respiratory failure group were significantly lower than those in the non-respiratory failure group(P<0.01).There was no significant difference in the change of LDL-C between the two groups(P>0.05).Pearson correlation analysis showed that PCT,IL-6 and CRP were significantly negatively correlated with PaO2,FEV1/pred and FEV1/FVC in the AECOPD patients(P<0.001),and positively correlated with PaCO2(P<0.001);TC,TG and HDL-C were positively correlated with P

关 键 词：慢性阻塞性肺疾病急性加重期 血脂 降钙素原 白介素-6 C反应蛋白 

分 类 号：R563.5[医药卫生—呼吸系统]