AECOPD患者生长激素和睾酮水平变化的初步探讨

发布时间：2018-12-05 20:16

【摘要】：目的通过比较COPD组与非COPD组;COPD轻、中度组与重、极重度组；肺心功能代偿组与肺心功能失代偿组之间的血清生长激素、睾酮水平有无差异,探讨AECOPD患者血清生长激素、睾酮的表达特征及其与病情的相关性,为进一步的激素干预治疗提供理论及实验依据,从而改善COPD患者的症状,减缓病程的发展,提高生活质量,减轻社会及经济负担。方法随机选取2011年10月-2012年10月入院的慢性阻塞性肺疾病男性患者为COPD组,根据肺功能结果分为轻、中度组和重、极重度组；重、极重度组再分为肺心功能代偿组和肺心功能失代偿组。随机选取同期入院的非COPD男性患者为非COPD组。COPD组和非COPD组均排除合并有肝肾功能衰竭、肿瘤、肺结核、糖尿病、结缔组织病、甲状腺疾病等慢性消耗性疾病,且近3月内未接受激素治疗及营养支持治疗。因正常情况下生长激素呈脉冲分泌,血中半衰期短,夜间睡眠状态下分泌明显增加,所以本实验于入院当天夜间0点抽取受试者空腹静脉血；血清睾酮水平受性别影响较大,男性比女性有更高的血清睾酮水平,生长激素也受性别影响,所以本研究均以男性为研究对象,以便于比较。生长激素和睾酮均采用化学发光法检测。同步抽取外周动脉血作血气分析；COPD组患者于病情稳定后作肺功能检查。统计学处理应用SPSS16.0统计分析软件进行数据分析。以完全随即设计的两样本比较的t检验比较COPD组与非COPD组;COPD轻、中度组与重、极重度组；肺心功能代偿组与肺心功能失代偿组之间的年龄、生长激素及睾酮水平。结果1.各组患者之间的年龄相比较,差别无统计学意义。 2. COPD组与非COPD组的血清生长激素、睾酮水平相比较,差别均有统计学意义(P0.01)。 3. COPD轻、中度组与COPD重、极重度组的血清生长激素、睾酮水平相比较,差别均有统计学意义(P0.05)。 4. COPD肺心功能代偿组与COPD肺心功能失代偿组的血清生长激素和睾酮水平相比较,差别均有统计学意义(P0.05)。结论1、COPD组的血清生长激素、睾酮水平明显低于非COPD组。 2、COPD重、极重度组的血清生长激素、睾酮水平低于COPD轻、中度组。 3、COPD肺心功能失代偿组的血清生长激素、睾酮水平低于COPD肺心功能代偿组。 4、随着病情的加重或严重并发症的出现,COPD患者血清生长激素、睾酮水平呈逐渐下降趋势。
[Abstract]:Objective to compare COPD group with non-COPD group, COPD mild group, moderate group and severe group. There were differences in serum growth hormone and testosterone levels between the lung heart function compensation group and the lung heart function decompensation group. The expression characteristics of serum growth hormone and testosterone in AECOPD patients and their correlation with the disease were investigated. To provide theoretical and experimental basis for further hormone intervention therapy, so as to improve the symptoms of patients with COPD, slow down the development of the course of disease, improve the quality of life, and reduce the social and economic burden. Methods male patients with chronic obstructive pulmonary disease (COPD) admitted from October 2011 to October 2012 were randomly selected as COPD group. According to the results of pulmonary function, they were divided into mild, moderate, severe and severe groups. The severe and severe groups were divided into two groups: lung heart function compensation group and lung heart function decompensation group. Non COPD male patients admitted in the same period were randomly selected as non COPD group. COPD group and non COPD group were excluded from chronic consumptive diseases such as liver and kidney failure, tumor, tuberculosis, diabetes, connective tissue disease, thyroid disease, etc. No hormone therapy and nutritional support therapy were received in the last three months. Under normal conditions, growth hormone was secreted by pulse, the half-life of blood was short, and the secretion of growth hormone was obviously increased during nighttime sleep, so the fasting venous blood was taken from the subjects at 0 o'clock at night on the day of admission. The serum testosterone level was significantly affected by sex, the male had higher serum testosterone level than the female, and the growth hormone was also affected by sex. Growth hormone and testosterone were detected by chemiluminescence. Peripheral arterial blood was extracted simultaneously for blood gas analysis, and pulmonary function was examined after stable condition in COPD group. Statistical analysis was carried out with SPSS16.0 software. T test was used to compare the age, growth hormone and testosterone levels between the COPD group and the non COPD group, the mild, moderate and severe groups of COPD, the lung heart function compensation group and the lung heart function decompensation group. Result 1. There was no significant difference in age between each group. 2. The serum levels of growth hormone and testosterone in COPD group and non-COPD group were significantly different (P0.01). 3. The serum levels of growth hormone and testosterone in the mild and moderate COPD group were significantly different from those in the severe COPD group and the very severe group (P0.05). 4. The serum levels of growth hormone and testosterone in COPD group and COPD group were significantly higher than those in COPD group (P0.05). Conclusion 1 the serum levels of growth hormone and testosterone in COPD group were significantly lower than those in non COPD group. 2 the serum levels of growth hormone and testosterone in the severe and severe COPD group were lower than those in the mild and moderate COPD group. 3 the serum levels of growth hormone and testosterone in COPD group were lower than those in COPD group. 4. The serum levels of growth hormone and testosterone in patients with COPD decreased gradually with the exacerbation of the disease or the appearance of severe complications.
【学位授予单位】：广西医科大学
【学位级别】：硕士
【学位授予年份】：2013
【分类号】：R563

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