慢性阻塞性肺疾病患者气道炎症反应、肺功能与生化指标相关性研究  

Correlation analysis of airway inflammatory response,pulmonary function and biochemical indicators in patients with COPD

作　　者：韩慧[1] 徐平[1] 宋卫东[1] HAN Hui;XU Ping;SONG Weidong(Department of Respiratory and Critical Care Medicine,Shenzhen Hospital,Peking University,Shenzhen 518036,China)

机构地区：[1]北京大学深圳医院呼吸与危重症医学科,广东深圳518036

出　　处：《陕西医学杂志》2023年第10期1358-1361,1366,共5页Shaanxi Medical Journal

基　　金：广东省深圳市科技计划项目(201103004)。

摘　　要：目的:分析慢性阻塞性肺疾病(COPD)患者气道炎症反应、肺功能、血清1,25-二羟基维生素D_(3)[1,25(OH)_(2)D_(3)]、钙离子(Ca^(2+))、镁离子(Mg^(2+))水平变化,并探究气道炎症反应、肺功能与血清1,25(OH)_(2)D_(3)、Ca^(2+)、Mg^(2+)的相关性。方法:选择COPD住院患者48例(急性加重组)和COPD门诊随访患者48例(稳定组),以40例同期无COPD病史的健康者为对照组。检测三组呼出气一氧化氮(FeNO)、C反应蛋白(CRP)、降钙素原(PCT)、第一秒用力呼气末容积(FEV1)、一秒率(FEV1/FVC)、血清1,25(OH)_(2)D_(3)、Ca^(2+)和Mg^(2+),并分析FeNO、CRP、PCT、FEV1、FEV1/FVC水平与1,25(OH)_(2)D_(3)、Ca^(2+)、Mg^(2+)水平的相关性。结果:随着COPD病情进展,患者FEV1、FEV1/FVC、1,25(OH)_(2)D_(3)、Ca^(2+)、Mg^(2+)水平均降低,急性加重组1,25(OH)_(2)D_(3)、Ca^(2+)、Mg^(2+)水平低于稳定组,同时患者FeNO、CRP、PCT水平均升高,急性加重组的FeNO、CRP、PCT水平高于稳定组(均P<0.05)。FeNO、CRP、PCT水平分别与1,25(OH)_(2)D_(3)、Ca^(2+)、Mg^(2+)水平呈负相关(均P<0.05),FEV1、FEV1/FVC水平分别与1,25(OH)_(2)D_(3)、Ca^(2+)、Mg^(2+)水平呈正相关(均P<0.05)。CRP、PCT是COPD急性加重的危险因素(均P<0.05),FEV1、FEV1/FVC、1,25(OH)_(2)D_(3)是COPD急性加重的保护因素(均P<0.05)。结论:气道炎症与1,25(OH)_(2)D_(3)、Ca^(2+)、Mg^(2+)水平呈负相关,肺功能与1,25(OH)_(2)D_(3)、Ca^(2+)、Mg^(2+)水平呈正相关,CRP、PCT是COPD急性加重的危险因素,FEV1、FEV1/FVC、1,25(OH)_(2)D_(3)是COPD急性加重的保护因素,其具体机制还有待深入研究。Objective:To analyze the changes of airway inflammatory response,pulmonary function and serum 1,25-dihydroxyvitamin D_(3)[1,25(OH)_(2)D_(3)],calcium ion(Ca^(2+))and magnesium ion(Mg^(2+))levels in patients with chronic obstructive pulmonary disease(COPD),and investigate the correlation between airway inflammation,lung function and serum 1,25(OH)_(2)D_(3),Ca^(2+),Mg^(2+).Methods:Forty-eight inpatients with COPD(acute exacerbation group)and 48 outpatients with COPD(stable group)were selected,and 40 healthy people without COPD history were selected as control group.The levels of fractional exhaled nitric oxide(FeNO),C-reactive protein(CRP),procalcitonin(PCT),forced end-expiratory volume in one second(FEV1),forced expiratory volume in one second(FEV1/FVC),serum 1,25(OH)_(2)D_(3),Ca^(2+)and Mg^(2+)were measured.The correlations of FeNO,CRP,PCT,FEV1,FEV1/FVC with 1,25(OH)_(2)D_(3),Ca^(2+),Mg^(2+)levels were analyzed.Results:With the progression of COPD,FEV1,FEV1/FVC,1,25(OH)_(2)D_(3),Ca^(2+)and Mg^(2+)levels decreased.The levels of 1,25(OH)_(2)D_(3),Ca^(2+)and Mg^(2+)in acute exacerbation group were lower than those in stable group,and the levels of FeNO,CRP and PCT increased,and the levels in acute exacerbation group were higher than those in stable group(all P<0.05).The levels of FeNO,CRP and PCT were negatively correlated with the levels of 1,25(OH)_(2)D_(3),Ca^(2+)and Mg^(2+)(all P<0.05).FEV1 and FEV1/FVC were positively correlated with the levels of 1,25(OH)_(2)D_(3),Ca^(2+)and Mg^(2+)(all P<0.05).CRP and PCT were risk factors for COPD acute exacerbation(all P<0.05),and FEV1,FEV1/FVC,1,25(OH)_(2)D_(3) were protective factors for COPD acute exacerbation(all P<0.05).Conclusion:Airway inflammation is negatively correlated with the levels of 1,25(OH)_(2)D_(3),Ca^(2+)and Mg^(2+).Pulmonary function is positively correlated with the levels of 1,25(OH)_(2)D_(3),Ca^(2+)and Mg^(2+).CRP and PCT are risk factors of COPD acute exacerbation,and FEV1,FEV1/FVC,1,25(OH)_(2)D_(3) are protective factors of COPD acute exacerbation,bu

关 键 词：慢性阻塞性肺疾病 气道炎症 肺功能 1 25-二羟基维生素D_(3) 血清钙 血清镁 

分 类 号：R563.9[医药卫生—呼吸系统]