稳定期慢性阻塞性肺疾病患者血管内皮功能的研究  

Study on vascular endothelial function in patients with stable chronic obstructive pulmonary disease

作　　者：杨发菊 华毛[1] YANG Fa-ju;HUA Mao(Department of Respiratory and Critical Care Medicine,Qinghai University/Qinghai University Affiliated Hospital,Xining,Qinghai 810000,China)

机构地区：[1]青海大学/青海大学附属医院呼吸与危重症医学科,青海西宁810000

出　　处：《临床肺科杂志》2023年第1期30-34,共5页Journal of Clinical Pulmonary Medicine

基　　金：青海省卫生健康委重点课题资助项目(No.2020-wjzd-04)。

摘　　要：目的探讨稳定期慢性阻塞性肺疾病(COPD)患者血管内皮损害情况,并分析内皮功能与肺功能指标及炎症细胞因子水平之间的相关性。方法选取2020年11月—2021年7月在青海大学附属医院就诊的COPD稳定期轻度、中度、重度、极重度患者各30例为病例组,同时选取60例健康对照。检测所有研究对象的血清内皮源性一氧化氮(eNO)、血栓调节蛋白(TM)、C-反应蛋白(CRP)水平,并测定肱动脉内皮依赖性舒张功能(FMD)及肺功能指标(FEV_(1)/FVC、FEV_(1)%pred)的数值。结果(1)四组研究对象血清eNO、TM水平均较对照组降低(P<0.05),CRP水平均较对照组升高(P<0.05)。(2)四组研究对象血清eNO、TM水平及FMD值与肺功能指标FEV_(1)%pred呈正相关(P<0.05),FMD值与血清CRP水平呈负相关(P<0.05)。结论稳定期COPD患者血管内皮功能下降,且其体内存在不同程度的炎症反应,COPD患者随气道阻塞严重程度的加重血管内皮功能恶化明显,而且炎症反应是血管内皮功能损伤的驱动因素。Objective To investigate vascular endothelial dysfunction in stable chronic obstructive pulmonary disease(COPD)patients,and to analyze the correlation between endothelial function and lung function indicators as well as inflammatory cytokine levels.Methods From November 2020 to July 2021,patients with mild,moderate,severe,and extremely severe COPD in the stable stage(thirty patients in each group)who were treated in the Affiliated Hospital of Qinghai University were selected as the case group.Meanwhile,sixty healthy subjects were included as the control group.The serum levels of endothelial nitric oxide(eNO),thrombomodulin(TM),and C-reactive protein(CRP)were measured,and the values of brachial artery endothelial-dependent relaxation function(FMD)and pulmonary function indexes(FEV_(1)/FVC,FEV_(1)%pred)were measured.Results(1)The level of serum eNO and TM values in the case group were lower than those in the control group(P<0.05).And the level of serum CRP in the case group was higher than those in the control group(P<0.05).(2)The serum eNO,TM levels,and FMD values in the case group were positively correlated with FEV_(1)%pred(P<0.05),and the FMD values were negatively correlated with the serum CRP levels(P<0.05).Conclusion The vascular endothelial function declines in stable COPD patients,and there is a varying degree of inflammatory response in their bodies.The vascular endothelial function deteriorates obviously with increasing severity of airway obstruction,and the inflammatory response is a driving factor of vascular endothelial function impairment.

关 键 词：慢性阻塞性肺疾病 血管内皮功能 血栓调节蛋白 C-反应蛋白 一氧化氮 

分 类 号：R563.9[医药卫生—呼吸系统]