脂联素在慢性阻塞性肺疾病不同分期的表达

Expression of Adiponectin in Different Stages of Chronic Obstructive Pulmonary Disease

目的 探讨慢性阻塞性肺疾病（ 简称慢阻肺） 急性加重期和稳定期外周血清中脂联素水平的变化, 及其与高敏C 反应蛋白（ hs-CRP） 和第1 秒用力呼气容积（ FEV1 ） 的相关性。方法 连续选择正常体重[ 体重指数（ BMI） 范围18. 5 ～24. 9 kg/m2 ] 的男性慢阻肺患者60 例, 其中急性加重期组和稳定期组各30 例, 同时纳入30 例男性健康体检者为正常对照组。采用ELISA 技术和胶体金法,分别测定血清中脂联素和hs-CRP 的表达水平, 并检查FEV1。所得资料采用非参数法和线性相关进行比较分析。结果 （ 1） 3 组脂联素浓度的秩均值经比较, 急性加重期组均高于稳定期组和正常对照组（ P 均〈0. 01） 。（ 2） 3 组hs-CRP 浓度的秩均值经比较, 急性加重期组高于稳定期组和正常对照组（ P 均〈0. 01） ; 稳定期组亦高于正常对照组（ P 〈0. 05） 。（ 3） 3 组FEV1 占预计值百分比的秩均值经比较, 急性加重期组均低于稳定期组和正常对照组（ P 均〈0. 01） ; 稳定期组亦低于正常对照组（ P 〈0. 01） 。（ 4） 急性加重期组和稳定期组患者的脂联素与hs-CRP和FEV1 均无相关性（ 散点图均不呈线性趋势） 。结论 慢阻肺急性加重期患者外周血清中脂联素和hs-CRP 的表达水平增高, 随着病情的稳定则下降, 且脂联素达正常水平。提示脂联素参与了慢阻肺的部分发病过程。

Objective To investigate the serum level of adiponectin in patients with chronicobstructive pulmonary disease（ COPD） at acute exacerbation or stable stage, and analyze the relationshipbetween adiponectin and high-sensitivity C-reactive protein（ hs-CRP） or expiratory volume in the first second（ FEV1 ） .Methods Sixty male COPD patients with nomal weight（ with BMI range of 18. 5-24. 9 kg/m2 ）were enrolled including 30 patients with acute exacerbation of COPD（ AECOPD） and 30 patients with stableCOPD. At the same time, 30 healthy volunteers were included as normal controls. The spirometry wasperformed. The serum levels of adiponectin and hs-CRP were measured by ELISA kit and Colloidal Goldmethod.Results The mean serumconcentration of adiponectin in the AECOPD group was higher than thosein the stable COPD group and the control group（ P 〈 0. 01） . The mean serum concentration of hs-CRP washigher in the AECOPD group than those in the stable COPD group and the control group（ P〈0. 01） , and washigher in the stable COPD group than those in the control group（ P 〈0. 05） . The FEV1% pred was significantlylower in the AECOPD group than that in the stable COPD group and the control group（ P 〈0. 01） , also lower inthe stable COPD group than that in the control group（ P 〈 0. 05） . In the AECOPD group and stable COPDgroup, correlation analysis show no relationship of adiponectin with hs-CRP or adiponectin with FEV1pred.Conclusion Serum concentrations of adiponectin and hs-CRP increase in acute exacerbation of COPD anddecrease with the stability of the disease, suggesting adiponectin may be involved in the pathogenesis of COPD.