不同临床类型慢性阻塞性肺疾病患者营养状态与炎性因子的研究

发布时间：2018-12-07 10:25

【摘要】：目的探讨不同临床类型慢性阻塞性肺疾病(简称慢阻肺)患者营养状态、血清瘦素、肿瘤坏死因子α(TNF-α)、白细胞介素8(IL-8)及C反应蛋白(CRP)水平的差异。方法选取2012年1月至2013年12月在核工业四一六医院呼吸内科住院或门诊随访的典型肺气肿型慢阻肺患者52例(急性期27例,稳定期25例;A组)和典型支气管炎型慢阻肺患者68例(急性期36例,稳定期32例;B组)。同期40例健康体检者为对照组。测量各组营养状态的各项指标[体重指数(BMI)、理想体重百分比、三头肌皮皱厚度、上臂中部臂围、白蛋白、淋巴细胞计数],采用放射免疫法检测血清瘦素、TNF-α、IL-8水平;采用全自动生化分析仪测定CRP水平。结果 B组营养状态的各项指标均明显高于A组(P0.05)。瘦素水平在A组稳定期及B组稳定期较对照组明显降低[(7.76±2.93)ng/L和(10.04±5.11)ng/L比(14.93±8.47)ng/L,P0.05],在A组急性期及B组急性期[(12.99±5.56)ng/L和(13.52±5.82)ng/L]分别较同组稳定期显著升高(P0.05),在A组稳定期[(7.76±2.93)ng/L]较B组稳定期[(10.04±5.11)ng/L]明显降低(P0.05)。TNF-α水平在A组急性期显著高于B组急性期及对照组[(234.65±95.74)μg/L和(195.03±88.00)μg/L比(182.07±42.35)μg/L,P0.05],在A组稳定期高于B组稳定期[(225.31±84.14)μg/L比(188.17±72.62)μg/L,P0.05]。IL-8水平在A组、B组急性期及稳定期均显著高于对照组(P0.05),A组、B组之间及急性期与稳定期之间IL-8水平无明显差异(P0.05)。A组和B组急性期CRP水平均显著高于对照组[(46.87±35.89)mg/L和(70.11±65.50)mg/L比(5.05±4.49)mg/L,P0.01],B组急性期CRP水平高于A组急性期(P0.05)。结论营养状态、瘦素、TNF-α和CRP水平在典型的肺气肿型及支气管炎型慢阻肺患者中有显著差异,而IL-8水平在两组中差异不大,瘦素和TNF-α可能参与慢阻肺营养不良的发生。
[Abstract]:Objective to investigate the nutritional status, serum leptin, tumor necrosis factor 伪 (TNF- 伪), interleukin-8 (IL-8) and C-reactive protein (CRP) levels in patients with different clinical types of chronic obstructive pulmonary disease (COPD). Methods from January 2012 to December 2013, 52 patients with typical emphysema slow obstructive pulmonary disease (27 in acute phase and 25 in stable stage) in Department of Respiratory Medicine, 416 Hospital of Nuclear Industry, were followed up. Group A and 68 patients with typical bronchitis chronic obstructive pulmonary disease (acute 36 cases, stable 32 cases; group B). In the same period, 40 healthy persons were taken as control group. The nutritional status of each group was measured [body mass index (BMI),) ideal weight percentage, triceps skin wrinkle thickness, midarm circumference of upper arm, albumin, lymphocyte count]. Serum leptin and TNF- 伪 were measured by radioimmunoassay. IL-8 level; The level of CRP was measured by automatic biochemical analyzer. Results the nutritional status of group B was significantly higher than that of group A (P 0.05). Leptin levels in group A and group B were significantly lower than those in control group [(7.76 卤2.93) ng/L and (10.04 卤5.11) ng/L vs (14.93 卤8.47) ng/L,P0.05]. In the acute phase of group A and group B, [(12.99 卤5.56) ng/L and (13.52 卤5.82) ng/L] were significantly higher than those in the stable phase of the same group (P0.05). The level of TNF- 伪 in group A [(7.76 卤2.93) ng/L] was significantly lower than that in group B [(10.04 卤5.11) ng/L] (P0.05). The level of TNF- 伪 in group A was significantly higher than that in group B and control group (P0.05). [(234.65 卤95.74) 渭 g / L vs (195.03 卤88.00) 渭 g / L: (182.07 卤42.35) 渭 g / L, The level of IL-8 in group A was significantly higher than that in group B [(225.31 卤84.14) 渭 g / L vs (188.17 卤72.62) 渭 g / L]. The acute and stable phase in group B was significantly higher than that in control group (P0.05). There was no significant difference in IL-8 level between group B and group B (P0.05) CRP levels in). A group and group B were significantly higher than those in control group [(46.87 卤35.89) mg/L and (70.11 卤65.50) mg/]. L ratio (5.05 卤4.49) mg/L, The level of CRP in group B was higher than that in group A (P 0.05). Conclusion there are significant differences in nutritional status, leptin, TNF- 伪 and CRP levels in patients with typical emphysema and bronchitis chronic obstructive pulmonary disease, but there is no significant difference in IL-8 level between the two groups. Leptin and TNF- 伪 may be involved in the development of chronic obstructive pulmonary malnutrition.
【作者单位】：核工业四一六医院呼吸内科;
【基金】：四川省卫生厅科研课题(编号:089142)
【分类号】：R563.9

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