血清鸢尾素在老年稳定期慢性阻塞性肺病相关肺动脉高压中的临床价值  

Clinical value of serum irisin in elderly patients with stable chronic obstructive pulmonary disease-related pulmonary hypertension

作　　者：张诚实 赵云峰[1] 鲁晓怡 刘明 崔栋慧 Zhang Chengshi;Zhao Yunfeng;Lu Xiaoyi;Liu Ming;Cui Donghui(Department of Respiratory Medicine,Punan Hospital,Pudong New District,Shanghai,200125,P.R.China)

机构地区：[1]上海市浦东新区浦南医院呼吸科,上海200125

出　　处：《老年医学与保健》2022年第1期140-143,共4页Geriatrics & Health Care

基　　金：上海市浦东新区卫健委面上项目(PW2019A-16);浦东新区卫生系统重点亚专科建设资助(PWZy2020-15)。

摘　　要：目的探讨血清鸢尾素在老年稳定期慢性阻塞性肺病相关肺动脉高压(COPD-PH)中的临床价值。方法选择2019年5月—2021年5月在上海市浦东新区浦南医院呼吸科就诊的老年COPD患者及健康体检者为研究对象,分为对照组(A组)、稳定期COPD组(B组)和COPD-PH组(C组)。根据心超测定肺动脉收缩压(PASP)结果,将C组分为轻度(C1组)、中度(C2组)和重度(C3组)3个亚组。所有研究对象均测定肺动脉收缩压(PASP)、血清鸢尾素、血浆IL-6、血浆IL-8、血浆NT-Pro BNP、动脉血气,记录患者肺功能和CAT问卷评分;比较各组各指标值间的差异。结果 A、B、C组两两比较以及C1、C2、C3组两两比较,PASP、血清鸢尾素、血浆IL-6、血浆IL-8、血浆NT-Pro BNP、pH值、PaO;、PaCO;、FEV1%、FEV1/FVC、CAT评分各指标之间的差异均有统计学意义(P<0.05)。在A、B、C组以及C1、C2、C3组,血清鸢尾素与PASP、血浆IL-6、血浆IL-8、血浆NT-ProBNP、PaCO;、CAT评分均呈负相关性,与pH值、PaO;、FEV1%、FEV1/FVC均呈正相关性。结论老年稳定期COPD患者血清鸢尾素水平明显低于健康体检者;随着肺动脉压力逐渐增高,COPD-PH患者血清鸢尾素水平逐渐降低。Objective To explore the clinical value of serum irisin in elderly patients with stable chronic obstructive pulmonary disease-related pulmonary hypertension(COPD-PH). Methods Elderly patients with COPD treated in Department of Respiratory Medicine of Punan Hospital from May2019 to May2021 and another healthy people were selected as the research subjects. They were divided into control group(group A),stable COPD group(group B)and COPD-PH group(group C). According to the results of pulmonary artery systolic blood pressure(PASP)measured by echocardiography,group C was divided into three subgroups:mild(group C1),moderate(group C2)and severe(group C3)subgroup.PASP,serum irisin,plasma IL-6,plasma IL-8,plasma NT-Pro BNP and arterial blood gas were measured in all subjects.Pulmonary function and CAT questionnaire scores were recorded. The differences in all indexes values were compared among different groups. Results There were significant differences in PASP,serum irisin,plasma IL-6,plasma IL-8,plasma NTPro BNP,pH value,PaO;,PaCO;,FEV1%,FEV1/FVC and CAT scores among groups A,B and C and among groups C1,C2 and C3(P< 0.05). In groups A,B and C and C1,C2 and C3,serum irisin was negatively correlated with PASP,plasma IL-6,plasma IL-8,plasma NT-pro BNP,PaCO;and CAT scores,and positively correlated with pH value,PaO;,FEV1% and FEV1/FVC. Conclusion The level of serum irisin in elderly patients with stable COPD was significantly lower than that in the healthy people. In elderly patients with COPD-PH,the level of serum irisin decreased gradually with the gradual increase of pulmonary artery pressure.

关 键 词：老年 慢性阻塞性肺疾病 肺动脉高压 血清 鸢尾素 

分 类 号：R259[医药卫生—中西医结合]