慢性阻塞性肺疾病急性加重期患者血糖血脂的表达特征

Characteristics of glucose and lipid metabolism in patients with chronic obstructive pulmonary disease of acute exacerbation

目的探讨慢性阻塞性肺疾病急性加重期(AECOPD)患者血糖、血脂的表达特征及其与病情的相关性。方法检测66例AECOPD患者,(其中34例为轻中度,32例为重度、极重度),及同期住院32例非COPD患者的空腹血清甘油三酯(TG)、胆固醇(CH)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)、载脂蛋白A1(APoA1)、载脂蛋白B(APoB)、糖化血红蛋白(HbAlc)、空腹血糖(FBG)、餐后2h血糖(P2hBG)、空腹及餐后2h胰岛素(IRI)的水平。结果 COPD组中的HbAlc、FBG、P2hBG、空腹IRI、餐后2hIRI水平均较非COPD组明显升高(P<0.01),其中COPD患者中重度、极重度组餐后2hIRI水平又高于轻中度组(P<0.05);COPD患者的TG、ApoB水平均比非COPD组降低(P<0.05),COPD重度、极重度组LDL-C水平比非COPD组及轻中度组升高(P<0.05)。结论 AECOPD患者尤其是重度、极重度阶段存在血糖、血脂紊乱,主要表现为高血糖、胰岛素抵抗、血脂异常。COPD组中LDL-C升高,提示COPD与冠心病(CHD)可能存在一定的相关性。

Objective To investigate the characteristics of glucose and lipid metabolism in patients with chronic obstructive pulmonary disease of acute exacerbation （AECOPD）, and its relationship with disease. Methods 66 cases AECOPD were detected, with 34 cases for mild and moderate group, 32 cases for severe and extremely severe group, in the same period, the hospital patients with non-COPD 32 cases of hollow serum triglyceride （ TG）, cholesterol （CH） , high- density lipoprotein cholesterol （HDL-C）, low density lipoprotein cholesterol （LDL-C）, apolipoprotein A1 （APoA1）, apolipoprotein B （APoB）, glycated hemoglobin （HbA1c）, fasting blood glucose （FBG）, postprandial blood glucose 2 h （P2hBG）, fasting and postprandial insulin 2 h （IRI） level. Results Compared with non-COPD group, the levels of HbAlc, FBG, P2hBG, IRI fasting, postprandial 2hIRI in COPD group were significantly higher than in non-COPD group （P 〈 0.01 ）. The level of postprandial 2 h IRI in severe and extremely severe COPD group was higher than that in mild and moderate COPD group （ P 〈 0.05 ）. The levels of TG, ApoB of the COPD group were lower than those of the non-COPD group（P 〈0.05）. but the level of LDL-C in patients of severe and extremely severe COPD group was higher than that in the mild and moderate COPD group and non-COPD patients （ P 〈 0.05 ）. Conclusions AECOPD patients with blood sugar, blood lipid disorders exist especially at severe and extremely severe stages, it main show high blood glucose, insulin resistance, dyslipidemia. LDL-C rises in COPD group, it prompting that there is some correlations between COPD and coronary heart disease （CHD）.