不同程度AECOPD患者血清25-(OH)Vit D和IGF-1及SF水平及其与肺功能相关性

Analysis the levels of 25-(OH)Vit D,IGF-1 and SF and its correlation with lung function in patients with different degrees of AECOPD

目的了解不同程度慢性阻塞性肺疾病急性加重期(AECOPD)患者血清25-羟基维生素D[25-(OH)Vit D]、胰岛素样生长因子1(IGF-1)及血清铁蛋白(SF)水平,并探讨其与肺功能的相关性。方法选择2021年1月-2022年3月深圳市龙岗中心医院呼吸与危重症医学科AECOPD确诊患者108例为研究组,同期健康体检者120人为对照组。于治疗前分别用肺功能分析仪测定第1秒用力呼气容积占预计值百分比(FEV1%pred)及第1秒最大呼气率(FEV1/FVC),同时对血清25-(OH)Vit D、IGF-1及SF水平进行检测,比较各组间是否存在差异,并分析25-(OH)Vit D与IGF-1、SF水平及肺功能的相关性。结果研究组25-(OH)Vit D、IGF-1、FEV1%pred及FEV1/FVC水平分别为(16.75±6.49)μmol/L、(78.12±19.25)ng/mL、(48.03±9.15)%及(47.06±7.52)%,明显低于对照组(43.08±4.26)μmol/L、(152.64±12.01)ng/mL、(87.16±6.24)%及(79.53±4.58)%(t=11.052、8.403、6.215、7.066,P均<0.05),而SF水平(329.65±83.97)ng/mL明显高于对照组(164.29±34.28)ng/mL(t=7.914,P<0.05),差异均有统计学意义。随AECOPD病情严重程度加重(Ⅰ~Ⅳ级),25-(OH)Vit D、IGF-1、FEV1%pred及FEV1/FVC水平呈明显降低(F=17.259、12.507、10.952、11.290,P均<0.05),而SF水平明显升高(F=8.265,P<0.05),差异有统计学意义,但Ⅰ级和Ⅱ级之间各指标差异均无统计学意义(P均>0.05)。经Pearson相关性分析,25-(OH)Vit D与IGF-1、FEV1%pred及FEV1/FVC水平成正相关,而与SF水平成负相关(r=0.809、0.590、0.602、-0.653,P均<0.05)。结论AECOPD患者25-(OH)Vit D和IGF-1水平明显降低,而SF水平明显升高,且与AECOPD分级及肺功能有关。加强上述指标检测对AECOPD早期诊断、病情评估及预防具有重要的临床意义。

Objective To understand the levels of serum 25-hydroxyvitamin D[25-hydroxyvitamin D,25-(OH)Vit D],insulin-like growth factor 1(IGF-1)and serum ferritin(SF)in the acute exacerbations of chronic obstructive pulmonary disease(AECOPD)with different degrees,and discuss the correlation between these markers and lung function.Methods From January 2021 to March 2022,108 cases of AECOPD confirmed patients in the Respiratory and Critical Care Medicine of Shenzhen Longgang Central Hospital were selected as the study group,and 120 healthy subjects were selected as the control group.Before treatment,the percentage of forced expiratory volume in the first second to the predicted value(FEV1%Pred)and the maximum expiratory rate in the first second(FEV1/FVC)were measured by pulmonary function analyzer.Meanwhile,the levels of 25-(OH)Vit D,IGF-1 and SF were detected,to compare whether there were differences among the groups and the correlation between 25-(OH)VitD and IGF-1,SF level and lung function was analyzed.Results The levels of 25-(OH)VitD,IGF-1,FEV1%pred and FEV1/FVC in control group were(16.75±6.49)μmol/L,(78.12±19.25)ng/mL,(48.03±9.15)%and(47.06±7.52)%,respectively,significantly lower than those in control group(43.08±4.26)μmol/L,(152.64±12.01)ng/mL,(87.16±6.24)%and(79.53±4.58)%,while the level of SF was(329.65±83.97)ng/mL,which was significantly higher than(164.29±34.28)ng/mL in control group;the difference was statistically significant(P<0.05).The levels of 25-(OH)Vit D,IGF-1,FEV1%pred and FEV1/FVC were significantly decreased,while the levels of SF were significantly increased with the severity of AECOPD;there were statistically significant differences among different degrees(P<0.05).But there was no significant difference between grade Ⅰ and grade Ⅱ(P>0.05).Pearson correlation analysis showed that 25-(OH)Vit D was positively correlated with IGF-1,FEV1%Pred and FEV1/FVC,while negatively correlated with SF(r=0.809,0.590,0.602,-0.653,all P<0.05).Conclusions The levels of 25-(OH)Vit D and IGF-1 decreased significantly in patients with AECOPD,while the level of SF increased significantly,which was related to AECOPD grade and lung function.Therefore,strengthening the detection of the above indicators had important clinical significance for the early diagnosis,disease evaluation and prevention of AECOPD.