血清脂联素与慢性阻塞性肺疾病急性加重期的相关性研究

Relationship between Serum Adiponectin and Acute Exacerbations of Chronic Obstructive Pulmonary Disease

目的通过研究慢性阻塞性肺疾病急性加重期(AECOPD)患者血清脂联素、白细胞、C反应蛋白等的变化,探讨脂联素与AECOPD的相关性,为AECOPD的治疗提供新的思路。方法选择AECOPD 60例(AECOPD组)及正常体检者60例(正常对照组)。所有研究对象常规测血压、身高、体质量,并计算体质量指数,于患者入院后次日取清晨空腹肘静脉血,分离血清,血球分析仪检测白细胞计数,全自动生化分析仪检测空腹血糖、血脂。采用全自动免疫分析仪定量分析测定C反应蛋白。剩余血清标本保存于-80℃冰箱采用酶联免疫分析法测定人脂联素水平。取桡动脉或股动脉血测血气分析。结果①2组一般情况比较无显著差异(P>0.05);AECOPD组的脂联素为(0.27±0.17)mg.L-1,正常对照组为(0.41±0.35)mg.L-1,2组比较差异有统计学意义(P<0.05)。②AE-COPD患者血清脂联素水平与白细胞、C反应蛋白呈负相关(r=-0.378,P=0.005;r=-0.349,P=0.005),与动脉血氧分压呈正相关(r=0.805,P=0.000)。结论 AECOPD患者存在低脂联素血症;脂联素与白细胞、C反应蛋白呈负相关,与动脉血氧分压呈正相关,进一步证实脂联素与AECOPD的炎症反应相关。

Objective To observe the changes in serum adiponectin（APN） levels,white blood cell（WBC） count and serum C-reactive protein（CRP） levels in patients with acute exacerbations of chronic obstructive pulmonary disease（AECOPD） to investigate the relationship between APN and AECOPD,and to provide new ideas for treatment of AECOPD.Methods Sixty patients with AECOPD（AECOPD group） and 60 normal subjects（control group） were recruited.Blood pressure,height,body weight and MBI were measured.The number of WBC was determined by hematology analyzer and fasting blood glucose and blood lipids were determined by automatic biochemical analyzer.CRP was detected by automated immunoassay analyzer and APN was detected by ELISA.Blood samples were drawn from radial artery or femoral artery for blood gas analysis.Results There were no differences in general conditions between the two groups（P0.05）.The levels of APN in AECOPD group were significantly lower than those in control group [（0.27±0.17） mg·L-1 vs（0.41±0.35）mg·L-1,P0.05）].APN levels were negatively correlated with WBC count and CRP levels（r=-0.378,P=0.005;r=-0.349,P=0.005,respectively）,and were positively correlated with PaO2（r=0.805,P=0.000）.Conclusion Patients with AECOPD has hypoadiponectinemia.APN levels were correlated with inflammation during AECOPD.