老年慢性阻塞性肺疾病相关肺动脉高压、高凝状态与血清脂联素、8-异前列腺素F_(2α)的关系  

Relationship of pulmonary hypertension and hypercoagulability with serum adiponectin and 8-isoprostaglandin F_(2α) in elderly patients with chronic obstructive pulmonary disease

作　　者：符沙沙 陈宗存[2] 王志峰 欧宗兴[4] FU Sha-sha;CHEN Zong-cun;WANG Zhi-feng;OU Zong-xing(Department of Respiratory and Critical Care Medicine,Hainan General Hospital,Haikou 570311,China;Department of Endocrinology,the Second Affiliated Hospital of Hainan Medical University,Haikou 570311,China;Department of Pneumology,Qionghai People s Hospital,Qionghai 571400,China;Department of Respiratory and Critical Care Medicine,the Affiliated Haikou Hospital of Xiangya Medical College,Central South University,Haikou 570208,China)

机构地区：[1]海南医学院附属海南医院(海南省人民医院)呼吸与危重症医学科,海南省海口市570311 [2]海南医学院第二附属医院内分泌科,海南省海口市570311 [3]琼海市人民医院呼吸内科,海南省琼海市571400 [4]中南大学湘雅医学院附属海口医院(海口市人民医院)呼吸与危重症医学科,海南省海口市570208

出　　处：《实用老年医学》2022年第2期180-183,共4页Practical Geriatrics

基　　金：海南省卫生计生行业科研项目(20A200489,19A200093);海南省自然科学基金资助项目(817386)。

摘　　要：目的探讨老年COPD相关肺动脉高压(PH)及高凝状态与血清脂联素、8-异前列腺素F_(2α)(8-iso-PGF_(2α))的关系。方法入选132例老年稳定期COPD病人,收集病人的年龄、性别、吸烟史、BMI、FEV1/FVC、纤维蛋白原(FIB)和D-二聚体(D-D)水平,采用心脏彩超检测肺动脉收缩压(PASP),根据PASP是否≥40 mmHg分为COPD伴PH组(56例)和单纯COPD组(76例)。采用ELISA法检测2组病人血清脂联素、8-iso-PGF_(2α)水平,分析PH、FIB、D-D与脂联素、8-iso-PGF_(2α)的关系。结果2组病人年龄、性别、吸烟史、BMI、血压、血糖和血脂差异无统计学意义(P>0.05)。COPD伴PH组病人8-iso-PGF_(2α)、FIB、D-D水平高于单纯COPD组,FEV1/FVC、脂联素水平低于单纯COPD组(P<0.05)。Logistic回归调整了年龄、性别、BMI、FEV1/FVC等混杂因素后,结果显示脂联素对PH有保护作用,8-iso-PGF_(2α)是PH的独立危险因素(P<0.05)。COPD伴PH组中,FIB、D-D与脂联素呈负相关,与8-iso-PGF_(2α)呈正相关(P<0.05)。结论老年COPD相关PH及高凝状态与脂联素、氧化应激有密切联系。Objective To investigate the relationship of pulmonary hypertension(PH)and hypercoagulability with serum adiponectin and 8-iso prostaglandin F_(2α)in the elderly patients with chronic obstructive pulmonary disease(COPD).Methods A total of 132 COPD patients at stable period were enrolled in this study.The patients were divided into COPD group(56 cases)and COPD combined with PH group(76 cases)according to whether pulmonary artery systolic pressure(PASP)was≥40 mmHg measured by echocardiography.The age,gender,smoking history,body mass index(BMI)and forced expiratory volume in the first second accounted for the percentage of forced vital capacity(FEV1/FVC)were collected.Serum levels of adiponectin and 8-iso prostaglandin F_(2α)were measured by enzyme linked immunosorbent assay.The levels of fibrinogen(FIB)and D-dimer(D-D)were also detected.Results There were no significant differences in age,gender,smoking history,BMI,blood pressure,blood glucose and blood lipid between the two groups(P>0.05).COPD with PH group had higher levels of 8-iso prostaglandin F_(2α),D-D,FIB and lower levels of FEV1/FVC and adiponectin than those in the COPD group(all P<0.05).After adjustment for age,gender,BMI,FEV1/FVC and other confounding factors by Logistic regression,adiponectin had negative effect and 8-iso prostaglandin F_(2α)had postive effect on PH(all P<0.05).In the COPD combined with PH group,FIB and D-D were negatively related to adiponectin,while positively related to 8-iso prostaglandin F_(2α)(all P<0.05).Conclusions The levels of adiponectin and oxidative stress are closely related to PH and hypercoagulability in the elderly patients with COPD complicated with PH.

关 键 词：慢性阻塞性肺疾病 肺动脉高压 脂联素 8-异前列腺素F_(2α) 高凝状态 

分 类 号：R563[医药卫生—呼吸系统] R563.9[医药卫生—内科学]