探讨维生素D与COPD急性加重频率、合并症及免疫反应的相关关系
发布时间：2018-11-11 14:35
【摘要】：目的:通过检测COPD患者血清VitD水平,以初步了解COPD患者VitD缺乏的情况及其对疾病严重程度的影响,并探讨VitD影响COPD患者病情的免疫学机制。方法:收集2016年3月-2016年11月在宁夏医科大学总医院呼吸科就诊的稳定期COPD患者60例,及与之年龄、性别、就诊时间匹配的健康体检者26例,通过电化学发光法检测所有受试者血清VitD浓度水平。收集COPD患者BMI、既往1年加重次数、CAT评分、是否存在心血管疾病的合并症、血钙和血磷等临床资料,并检测肺功能,比较Vit D缺乏组COPD患者与VitD不缺乏组的患者上述指标的差异,来了解VitD对COPD患者病情严重程度的影响。同时检测COPD患者组的抗核抗体(ANAs)、IL-10及TGF-β1的水平,分析VitD与上述指标的相关性。结果:COPD组患者的VitD水平明显低于对照组[(14.534?7.313)vs(24.42?10.909)ng/ml];(P0.05)];COPD患者VitD缺乏的患病率(73.01%)明显高于对照组的,差异有统计学意义(P0.05);缺乏VitD的COPD患者的血Ca低于不缺乏VitD的COPD患者[(2.16?0.116)vs(2.25?0.115)nom/l;(P0.05)];缺乏VitD的COPD患者FEV1/预计值(%)低于不缺乏VitD的COPD患者[(47.33?16.31)vs(58.43?17.784)%;(P0.05)];VitD缺乏的COPD患者CAT评分分值高于VitD不缺乏组的[(20.57?2.986)vs(18.64?3.342);(P0.05)]。VitD缺乏的COPD患者IL-10水平低于VitD不缺乏组[(24.73?2.834)vs(28.187?4.541)pg/ml;(P0.05)];VitD缺乏组的COPD患者的TGF-β1水平低于VitD不缺乏的患者[(1.29?0.499)vs(1.73?0.687)pg/ml;(P0.05)],COPD患者VitD与ANAs阳性患病率无相关关系。结论:COPD患者的血清VitD水平较对照组低,同时其VitD缺乏的患病率较健康对照组明显增高。VitD缺乏的COPD患者其生活质量及肺功能更差,同时其既往加重次数更多,病情更严重。VitD未通过产生抗核抗体(ANAs)的机制来影响COPD的病情进展;VitD缺乏的COPD患者其IL-10、TGF-β1水平显著低于VitD不缺乏组,VitD可能通过促进IL-10、TGF-β1的分泌而发挥免疫调节功能。
[Abstract]:Objective: to investigate the level of serum VitD in patients with COPD and its influence on the severity of VitD in COPD patients, and to explore the immunological mechanism of VitD affecting the patients with COPD. Methods: from March 2016 to November 2016, 60 patients with stable COPD, 26 matched with age, sex and time, were collected from Department of Respiratory, General Hospital of Ningxia Medical University. The concentration of serum VitD in all subjects was measured by electrochemiluminescence (ECL). The clinical data of BMI, exacerbation in one year, CAT score, complication of cardiovascular disease, serum calcium and phosphorus were collected in patients with COPD, and pulmonary function was measured. In order to understand the influence of VitD on the severity of COPD, we compared the above indexes between COPD patients with Vit D deficiency and those with no VitD deficiency. At the same time, the levels of (ANAs), IL-10 and TGF- 尾 1 were detected in patients with COPD, and the correlation between VitD and the above indexes was analyzed. Results: the level of VitD in COPD group was significantly lower than that in control group [(14.534 卤7.313) vs (24.42) vs (10.909 ng/ml]; (P0.05); The prevalence of VitD deficiency in COPD patients (73.01%) was significantly higher than that in the control group (P0.05). The serum Ca in COPD patients with VitD deficiency was lower than that in COPD patients without VitD [(2.160.116) vs (2.250.115) nom/l; (P0.05)]; The FEV1/ predictive value (%) of COPD patients without VitD was lower than that of COPD patients without VitD deficiency [(47.33 ~ 16.31) vs (58.43 ~ 17.784)%; (P0.05)]; The CAT score of COPD patients with VitD deficiency was higher than that of COPD patients without VitD deficiency [(20.570.986) vs (18.643.342)]. (P 0.05). The level of IL-10 in COPD patients with VitD deficiency was lower than that in patients without VitD deficiency [(24.732.834) vs (28.1874.541) pg/ml; (P0.05)]; The levels of TGF- 尾 1 in COPD patients with VitD deficiency were lower than those without VitD deficiency [(1.290.99) vs (1.730.687) pg/ml; (P0.05)]. There was no correlation between VitD and ANAs positive prevalence in COPD patients. Conclusion: the serum VitD level of COPD patients is lower than that of the control group, and the prevalence of VitD deficiency is significantly higher than that of the healthy control group. The quality of life and lung function of COPD patients with VitD deficiency are worse, and the number of previous exacerbations is more frequent. VitD did not influence the progression of COPD through the mechanism of producing (ANAs); The level of IL-10,TGF- 尾 1 in COPD patients with VitD deficiency was significantly lower than that in patients without VitD deficiency. VitD may play an immunomodulatory role by promoting the secretion of IL-10,TGF- 尾 1.
【学位授予单位】：宁夏医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R563.9
本文编号：2325137
[Abstract]:Objective: to investigate the level of serum VitD in patients with COPD and its influence on the severity of VitD in COPD patients, and to explore the immunological mechanism of VitD affecting the patients with COPD. Methods: from March 2016 to November 2016, 60 patients with stable COPD, 26 matched with age, sex and time, were collected from Department of Respiratory, General Hospital of Ningxia Medical University. The concentration of serum VitD in all subjects was measured by electrochemiluminescence (ECL). The clinical data of BMI, exacerbation in one year, CAT score, complication of cardiovascular disease, serum calcium and phosphorus were collected in patients with COPD, and pulmonary function was measured. In order to understand the influence of VitD on the severity of COPD, we compared the above indexes between COPD patients with Vit D deficiency and those with no VitD deficiency. At the same time, the levels of (ANAs), IL-10 and TGF- 尾 1 were detected in patients with COPD, and the correlation between VitD and the above indexes was analyzed. Results: the level of VitD in COPD group was significantly lower than that in control group [(14.534 卤7.313) vs (24.42) vs (10.909 ng/ml]; (P0.05); The prevalence of VitD deficiency in COPD patients (73.01%) was significantly higher than that in the control group (P0.05). The serum Ca in COPD patients with VitD deficiency was lower than that in COPD patients without VitD [(2.160.116) vs (2.250.115) nom/l; (P0.05)]; The FEV1/ predictive value (%) of COPD patients without VitD was lower than that of COPD patients without VitD deficiency [(47.33 ~ 16.31) vs (58.43 ~ 17.784)%; (P0.05)]; The CAT score of COPD patients with VitD deficiency was higher than that of COPD patients without VitD deficiency [(20.570.986) vs (18.643.342)]. (P 0.05). The level of IL-10 in COPD patients with VitD deficiency was lower than that in patients without VitD deficiency [(24.732.834) vs (28.1874.541) pg/ml; (P0.05)]; The levels of TGF- 尾 1 in COPD patients with VitD deficiency were lower than those without VitD deficiency [(1.290.99) vs (1.730.687) pg/ml; (P0.05)]. There was no correlation between VitD and ANAs positive prevalence in COPD patients. Conclusion: the serum VitD level of COPD patients is lower than that of the control group, and the prevalence of VitD deficiency is significantly higher than that of the healthy control group. The quality of life and lung function of COPD patients with VitD deficiency are worse, and the number of previous exacerbations is more frequent. VitD did not influence the progression of COPD through the mechanism of producing (ANAs); The level of IL-10,TGF- 尾 1 in COPD patients with VitD deficiency was significantly lower than that in patients without VitD deficiency. VitD may play an immunomodulatory role by promoting the secretion of IL-10,TGF- 尾 1.
【学位授予单位】：宁夏医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R563.9
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