血清瘦素在不同时期慢性阻塞性肺疾病患者中的表达及意义探讨

Expression and clinical significance of serum leptin in patients with chronic obstructive pulmonary disease in various phases

目的探讨慢性阻塞性肺疾病（COPD）患者不同时期血清瘦素水平的变化,以了解COPD患者炎症发生发展过程中瘦素的作用及其意义。方法选择COPD患者共53例,COPD急性加重期（Ⅰ组）26例,COPD缓解期（Ⅱ组）27例。正常对照组26例。测定和计算各组的多项营养指标,包括身高、体重、体重指数（BMI）、理想体重百分比（NM%）、体脂百分比（fat%）、三头肌皮皱厚度（TSF）、肩胛下皮皱厚度（SSF）、腹部皮皱厚度（ASF）、上臂中部臂围（MAC）、上臂肌围长（MAMC）、血清白蛋白（ALB）、前白蛋白（pro-ALB）、总淋巴细胞计数（LYM）。用放射免疫法测定53例COPD患者和26例正常人的血清瘦素。结果①COPD患者的各营养指标：BMI、NM%、fat%、TSF、SSF、ASF、MAC、MAMC、ALB、pro-ALB、LYM均显著低于正常对照组（P〈0.01）。②COPDⅠ组血清瘦素[（6.86±2.56）μg/L]显著高于正常组[（3.99±1.19）μg/L]与COPDⅡ组[（2.46±1.41）μg/L]（P〈0.01）;COPDⅡ组血清瘦素显著低于正常组（P〈0.01）。结论瘦素在急性加重期明显高于缓解期,因此可作为慢性阻塞性肺疾病急性加重期的炎性标志物。瘦素水平的表达可能是导致COPD患者能量代谢失衡,加重营养不良恶性循环的危险因素。

Objective To investigate the expression and clinical significance of serum leptin in the patients with COPD in various periods. Methods Twenty-six COPD patients in acute exacerbations phase （group Ⅰ ）,27 COPD patients in stationary phase （group Ⅲ ） and 26 healthy controls were studied. Body height, body mass, body mass index（BMI）, percentage of normal body mass （ NM% ）, percentage of body fat （fat%）, triceps skin-fold thickness （TSF）, subscapular skin-fold thickness （SSF）, abdominal skin-fold thickness（ ASF）, mid-upper arm circumference （ MAC）, mid-upper arm muscle circumference （ MAMC）, serum albumin（ALB）, pro-albumin （pro-ALB）, total lymphocyte counts （LYM） were determined. Serum leptin was measured by radioimmunoassay. Results （1）BMI, NM%, fat%, TSF, SSF, ASF, MAC, MAMC, ALB,pro-ALB and LYM in COPD patients Were significantly lower than those in healthy controls（ P 0.01）. （2） Serum leptin level was significantly higher in group Ⅰ （6.86±2.56）μg/L than that in healthy controls （3.99 ± 1.19）μg/L and in group Ⅲ （2. 46±1.41 ） μg/L （P 〈 0. 01）; Serum leptin level was significantly lower in group Ⅲ than that in healthy controls （ P 〈 0.01）. Conclusions The leptin is an inflaming mark of the acute exacerbation phase in the patients with COPD and can be a risk factor of repeating the infection.