COPD患者血脂比值和氧化应激状态及其与肺动脉高压及预后的关系

发布时间：2018-10-12 20:03

【摘要】：目的:探讨慢性阻塞性肺疾病(chronic obstructive pulmonary disease,COPD)患者血脂比值和氧化应激状态与其肺动脉高压及预后的关系。方法:随机选取河北省人民医院COPD患者120例为COPD组,另选取30例同期体检健康者为对照组。检测对照组和COPD组急性加重期和稳定期的低密度脂蛋白(LDL)/高密度脂蛋白(HDL)、三酰甘油(TG)/HDL、总胆固醇(TC)/HDL等血脂比值和血清超氧化物歧化酶(SOD)、丙二醛(MDA)和总抗氧化能力(total antioxidative capability,T-AOC)等氧化应激指标水平,统计其肺动脉高压的发生率和3年生存率并采用Spearman秩相关法分析其血脂比值和氧化应激状态与其肺动脉高压的发生率和3年生存率的关系。结果:与对照组比较,COPD组急性加重期和稳定期的LDL/HDL,TG/HDL,TC/HDL等血脂比值和血清MDA水平均升高,血清SOD和T-AOC水平则降低;与稳定期比较,COPD组急性加重期的血脂比值和血清MDA水平均升高,血清SOD和T-AOC水平则降低(P0.05)。COPD组随访3年间肺动脉高压的发生率和3年生存率分别为56.67%和81.67%,且出现肺动脉高压和死亡的COPD患者的急性加重期和缓解期的血脂比值和血清MDA水平均高于无肺动脉高压和存活患者,血清SOD和T-AOC水平则低于无肺动脉高压和存活患者(P0.05)。Spearman秩相关法分析结果显示,COPD患者LDL/HDL,TG/HDL,TC/HDL等血脂比值和血清MDA水平与其3年间肺动脉高压的发生率均呈正相关(r=0.752,0.748,0.773,0.734;P0.05),与其3年生存率则呈负相关(r= 0.722, 0.751, 0.736, 0.748;P0.05);COPD患者血清SOD和T-AOC水平与其3年间肺动脉高压的发生率均呈负相关(r= 0.711, 0.734;P0.05),与其3年生存率则呈正相关(r=0.726,0.733;P0.05)。结论:COPD患者血脂比值和氧化应激水平均较高,抗氧化能力则降低,且其血脂比值和氧化应激状态与其肺动脉高压及预后均相关,这可能和血脂与动脉硬化及营养状态相关和氧化应激影响COPD患者血管内皮功能等相关,因此COPD患者血脂比值和氧化应激状态可能用于其肺动脉高压及预后的评估。
[Abstract]:Objective: to investigate the relationship between the ratio of blood lipid and oxidative stress and pulmonary hypertension and prognosis in patients with chronic obstructive pulmonary disease (chronic obstructive pulmonary disease,COPD). Methods: 120 COPD patients in Hebei Provincial people's Hospital were randomly selected as COPD group and 30 healthy persons as control group. Serum lipid ratios of low density lipoprotein (LDL) / high density lipoprotein (HDL), triglyceride (TG) / HDL, total cholesterol (TC) / HDL, serum superoxide dismutase (SOD), malondialdehyde (SOD), MDA) and total antioxidant capacity (total) were measured in control group and COPD group during acute exacerbation and stabilization. Antioxidative capability,T-AOC) and other oxidative stress indexes, The incidence and 3-year survival rate of pulmonary hypertension were analyzed by Spearman rank correlation method. The relationship between the ratio of blood lipid and oxidative stress and the incidence and 3-year survival rate of pulmonary hypertension was analyzed by Spearman rank correlation method. Results: compared with the control group, the ratio of serum lipids such as LDL/HDL,TG/HDL,TC/HDL and serum MDA and the levels of serum SOD and T-AOC in COPD group were higher than those in control group, and the ratio of serum lipids and serum MDA in COPD group in acute exacerbation period were higher than those in control group, and the levels of serum SOD and T-AOC in COPD group were higher than those in control group. Serum SOD and T-AOC levels decreased (P0.05 in the). COPD group, the incidence of pulmonary hypertension and the 3-year survival rate were 56.67% and 81.67%, respectively. The ratio of blood lipids and blood lipid in the acute exacerbation and remission stage of COPD patients with pulmonary hypertension and death was 56.67% and 81.67%, respectively. The level of serum MDA was higher in patients without pulmonary hypertension and survival. Serum SOD and T-AOC levels were lower than those in patients without pulmonary hypertension and survival (P0.05). Spearman rank correlation analysis showed that there was a positive correlation between the ratio of LDL/HDL,TG/HDL,TC/HDL and serum MDA and the incidence of pulmonary hypertension in three years in COPD patients (RPV 0.7520.7480.7730.7730.34P05), and the results showed that there was a positive correlation between the ratio of serum lipids and LDL/HDL,TG/HDL,TC/HDL and the incidence of pulmonary hypertension (P 0.05). The annual survival rate was negatively correlated with the incidence of pulmonary hypertension (r = 0.722, P < 0. 751, r = 0. 736, P < 0. 748) and the incidence of pulmonary hypertension in 3 years (r = 0. 711, 0. 734 卤0. 05), and was positively correlated with the 3 year survival rate (r = 0. 726, 0. 733, P 0.05). Conclusion: the ratio of blood lipids and the level of oxidative stress in patients with COPD are higher than those in patients with COPD, but the antioxidant ability is decreased. The ratio of lipid and oxidative stress is related to pulmonary hypertension and prognosis. This may be related to the relationship between blood lipids and arteriosclerosis and nutritional status and the effect of oxidative stress on vascular endothelial function in patients with COPD. Therefore, the ratio of serum lipids and oxidative stress in patients with COPD may be used to evaluate pulmonary hypertension and prognosis.
【作者单位】：河北省人民医院感染性疾病科;河北省人民医院呼吸科;
【分类号】：R563.9;R544.1

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