血清肌抑素水平变化与慢性阻塞性肺疾病稳定期患者营养不良的关系研究

Clinical study on relationship between circulating myostatin and malnutrition in patients with chronic obstructive pulmonary disease

目的观察慢性阻塞性肺疾病(COPD)患者外周血中血清肌抑素水平的变化,探讨肌抑素与COPD患者营养不良的关系。方法选取COPD稳定期住院患者76例及健康对照者80例,通过营养不良参数评分(MNI)对所有受试者进行营养状况评价,并采取酶联免疫吸附法检测各组受试者血清中的肌抑素及肿瘤坏死因子-α(TNF-α)水平。结果 COPD组患者的MNI分值高于健康对照组,差异均有统计学意义(P<0.01)。其中COPD组MNI分值≥5分者占81.6%(62/76),MNI分值<5分者仅占18.4%(14/76)。COPD组患者的肌抑素及TNF-α水平均显著高于健康对照组(P<0.05)。COPD组患者血清肌抑素水平与MNI评分及TNF-α水平呈正相关(r=0.425,P=0.015;r=0.484,P=0.03)。结论多数COPD患者存在营养不良,其体内血清肌抑素水平较同龄健康人明显升高,肌抑素与COPD营养不良的发生关系密切。

【Objectives】 To observe the changes of serum levels in patients with stable chronic obstructive pulmonary disease（COPD） and to investigate the relationship between serum myostatin and malnutrition in COPD. 【Methods】 Seventy-six patients with stable COPD and 80 age-matched healthy volunteers were recruited in this study. The severity of malnutrition was evaluated by multiple-parameter malnutritional index（MNI） in all of the subjects. Serum concentration of myostatin and TNF- α were tested by enzyme-linked immunosorbent assay. 【Results】 The MNI score was significantly elevated in patients with COPD compared with the controls（P〈0.01）, and 62 patients（81.6%） in COPD group showed MNI ≥5 score. The serum myostatin and TNF- α levels were also significantly elevated in patients with COPD（P〈0.05）. Pearson correlation analysis showed that serum myostatin levels were significantly correlated with MNI and TNF- α（r =0.425, P =0.015; r =0.484, P =0.03）. 【Conclusion】 Most of the patients with COPD have malnutrition. The serum myostatin level is elevated and is correlated with the malnutritionin patients with COPD. The elevation of serum myostatin closely related to the malnutrition in COPD patients.