慢性阻塞性肺疾病患者血浆瘦素和肿瘤坏死因子-α水平的变化及其与肺功能和胰岛素抵抗的相关性分析  

Changes of Plasma Leptin and Tumor Necrosis Factor-αLevels in Patients with Chronic Obstructive Pulmonary Disease and Its Correlation with Lung Function and Insulin Resistance

作　　者：冯友[1] 肖亚军 杨兰 FENG You;XIAO Ya-jun;YANG Lan(Department of Geriatrics,the Third People's Hospital of Mianyang,Mianyang,Sichuan 621000,China;Department of Geriatrics,903 Hospital,Mianyang,Sichuan 621000,China)

机构地区：[1]绵阳市第三人民医院老年科,四川绵阳621000 [2]九〇三医院老年科,四川绵阳621000

出　　处：《解放军医药杂志》2020年第6期77-80,共4页Medical & Pharmaceutical Journal of Chinese People’s Liberation Army

基　　金：四川省卫生和计划生育委员会科研课题(18PJ249)。

摘　　要：目的分析慢性阻塞性肺疾病(COPD)患者血浆瘦素和肿瘤坏死因子-α(TNF-α)水平的变化及其与肺功能及胰岛素抵抗的相关性。方法回顾性分析2014年10月—2019年10月收治的90例COPD患者的临床资料,根据其病情分为稳定组和急性加重组,每组45例。再选取30例同时间段的健康体检者作为对照组。观察3组的血浆瘦素、TNF-α、肺功能指标及胰岛素抵抗指数(HOMA-IR)的变化,分析其相关性。结果急性加重组瘦素、TNF-α、空腹血糖(FPG)、胰岛素及HOMA-IR水平均明显高于稳定组和对照组,而第1秒用力呼气容积(FEV 1)占预计值百分比以及FEV 1/用力肺活量(FVC)明显低于稳定组和对照组(P<0.05)。稳定组胰岛素、HOMA-IR水平明显高于对照组,FEV 1占预计值百分比以及FEV 1/FVC均明显低于对照组(P<0.05)。随着COPD分级的增加,患者的FEV 1占预计值百分比以及FEV 1/FVC水平逐渐降低(P<0.05)。COPD患者的血浆瘦素和TNF-α水平与FEV 1占预计值百分比以及FEV 1/FVC呈负相关,而与FPG、胰岛素、HOMA-IR、COPD分级呈正相关(P<0.05或P<0.01)。结论血浆瘦素和TNF-α水平与COPD患者肺功能及胰岛素抵抗具有一定相关性,瘦素和TNF-α水平越高,肺功能越低,HOMA-IR越高。Objective To analyze the changes of plasma leptin and tumor necrosis factor-α(TNF-α)levels in patients with chronic obstructive pulmonary disease(COPD)and its correlation with lung function and insulin resistance.Methods A retrospective analysis of the clinical data of 90 COPD patients admitted from October 2014 to October 2019 was performed.They were divided into stable group and acute exacerbation group according to their condition,with 45 cases in each group.Then 30 healthy subjects during the same period were selected as the control group.The changes of plasma leptin,TNF-α,lung function indexes and insulin resistance index(HOMA-IR)in the three groups were observed,and the correlations were analyzed.Results The levels of plasma leptin,TNF-α,fasting plasma glucose(FPG),insulin and HOMA-IR in the acute exacerbation group were significantly higher than those of the stable group and the control group,and the predicted percentage of the forced expiratory volume in the first second(FEV 1 Pred)and the forced expiratory volume in the first second(FEV 1)/forced vital capacity(FVC)were significantly lower than those of the stable group and the control group(P<0.05).The levels of insulin and HOMA-IR in the stable group were significantly higher than those in the control group,and FEV 1 Pred and FEV 1/FVC were significantly lower than those in the control group(P<0.05).With the increase of COPD grade,the patient's FEV 1 Pred and FEV 1/FVC level were gradually decreased(P<0.05).The levels of plasma leptin and TNF-αin patients with COPD were negatively correlated with FEV 1 Pred and FEV 1/FVC,but positively correlated with FPG,insulin,HOMA-IR and COPD grades(P<0.05 or P<0.01).Conclusion Plasma leptin and TNF-αlevels have a certain correlation with lung function and insulin resistance in COPD patients,the higher the leptin and TNF-αlevels,the lower the lung function and the higher the HOMA-IR.

关 键 词：慢性阻塞性肺疾病 瘦素 肿瘤坏死因子-Α 用力肺活量 血糖 胰岛素抵抗 

分 类 号：R563.9[医药卫生—呼吸系统]