慢性阻塞性肺疾病患者血浆食欲素A水平的变化及其意义

The change and significance of plasma orexin-A levels in patients with chronic obstructive pulmonary disease

目的初步探讨慢性阻塞性肺疾病(COPD)患者血浆食欲素A(orexinA)水平变化及其意义。方法选择伴有肥胖的COPD患者15例(肥胖COPD组)、不伴有肥胖的COPD患者20例(非肥胖COPD组)、单纯肥胖者20例(单纯肥胖组)和健康成人20例(正常对照组)。所有受试者均接受肺功能检查及血气分析,采用层析方法将血浆去蛋白处理,然后采用放射免疫分析法测定4组血浆食欲素A的水平。结果肥胖COPD组(8.82ngL±1.90ngL)与非肥胖COPD组(8.69ngL±1.84ngL)血浆食欲素A水平显著高于单纯肥胖组(7.18ngL±1.45ngL)及正常对照组(6.72ngL±1.58ngL)(P<0.01)。肥胖COPD组与非肥胖COPD组血浆食欲素A水平无显著差异(P>0.05)。肥胖与非肥胖COPD组检测指标相关分析显示:血浆食欲素A水平与氧分压(PO2)(r=-0.527,P<0.01)、血氧饱和度(SaO2)(r=-0.529,P<0.01)呈负相关,而与二氧化碳分压(PCO2)、FEV1占预计值的百分比以及体重指数(BMI)、脂肪百分比(%fat)无相关性。结论COPD患者血浆食欲素A水平升高,其原因可能与COPD患者气道阻塞所致低氧血症及其病理生理变化有关。

Objective To investigate the change of plasma orexin-A levels in patients with chronic obstructive puhnonary disease （COPD）. Methods Lung function test and blood gas analysis were performed in 15 obese COPD patients （obese COPD group）, 20 COPD patients without obesity（non-obese COPD group）, 20 obese adults （obese group） and 20 healthy subjects （control group）, In both obese COPD group and obese group, the body mass index （BMI） was higher than 25 and there was no significant difference in BMI. Theplasma was deproteinized by chromatography, and the plasma orexin-A levels were determined by radioimmunoassay. Results The plasma orexin- A levels in the obese COPD group （8.82 ± 1.90） ng/L and the non-obese COPD group （8.69 ± 1.84） ng/L were significantly higher than those in the obese group （7, 18 ± 1.45）ng/L （ P 〈 0.01） and the control group （6.72 ± 1.58） ng/L （ P 〈 0.01） respectively, There was no sibmificant difference in plasma orexin-A levels between obese COPD group and non-obese COPD group （ P 〉 0.05）. Plasma orexin-A levels in patients with COPD correlated negatively with partial pressure of oxygen （PO2） （ r = -0.527, P 〈0.01） and oxygen saturation（SaO2）（ r = -0.529, P 〈 0. 01）. In the two COPD groups, plasma orexin-A levels did not correlate with partial pressure of carbon dioxide （PCO2）, FEV, percentage of predicted, BMI and percent of fat （ % fat）, Conclusion The plasma orexin-A levels in COPD patients are increased and correlated with the pathophysiological changes of hypoxia resulted from COPD.