慢性阻塞性肺疾病患者血清中脂联素水平的变化及其与肺功能的相关性

Changes of serum adiponectin and its correlation with lung function in patients with chronic obstructive pulmonary disease

目的通过研究慢性阻塞性肺疾病(COPD)患者肺功能及血清中脂联素水平的变化,探讨脂联素在COPD发病机制中的作用及其与肺功能的相关性。方法选取2012年6月至2014年1月住院的COPD急性加重期(AECOPD)男性患者30例,其中AECOPDⅡ级12例,Ⅲ级13例,Ⅳ级5例;COPD稳定期男性患者30例,其中COPDⅡ级13例,Ⅲ级13例,Ⅳ级4例;男性体检者健康对照30例。收集所有入选者的年龄、身高、体重及病程等资料,测定其肺功能,并采用双抗体夹心酶联免疫吸附(ABC-ELISA)法检测入选者血清脂联素水平。结果AECOPD组的第一秒用力呼气容积占预计值百分比(FEV1%pred)、第一秒用力呼气容积占用力肺活量百分比(FEV1/FVC%)较COPD稳定期组及健康对照组明显降低(P均<0.01),残气量占预计值百分比(RV%pred)较COPD稳定期组及健康对照组明显增高(P均<0.01);COPD稳定期组的FEV1%pred、FEV1/FVC%较健康对照组明显降低(P均<0.01),RV%pred较健康对照组明显增高(P<0.01)。AECOPD组的血清脂联素较COPD稳定期组及健康对照组明显增高(P均<0.01);COPD稳定期组的血清脂联素较健康对照组明显增高(P<0.01);AECOPD组和COPD稳定期组患者血清脂联素水平与FEV1%pred(r=-0.826,r=-0.729,P均<0.01)和FEV1/FVC%(r=-0.624,r=-0.661,P均<0.01)均呈负相关,与RV%pred呈正相关(r=0.715,r=0.902,P均<0.01)。结论脂联素参与了COPD慢性气道炎症的发生发展,可作为COPD一种新的炎症标志物。

Objective To investigate the changes of pulmonary function and adiponectin level in patients with chronic obstructive pulmonary disease（COPD） in order to explore the role of adiponectin in pathogenesis of COPD and its correlation with pulmonary function.Methods Thirty male patients with acute exacerbation phase of COPD（AECOPD group,AECOPD classification：12 cases for grade Ⅱ,13 cases for grade Ⅲ,5 cases for grade Ⅳ） and 30 male patients with COPD stable phase（stable phase group,COPD classification：13 cases for grade Ⅱ,13 cases for grade Ⅲ,4 cases for grade Ⅳ） who admitted in the third people’ s hospital of Zhengzhou city between June 2012 and January 2014 were selected.In addition,30 healthy male subjects were selected as control group.The participants,data of age,height,body weight and course of disease were collected.The pulmonary functions were measured,and the serum adiponectin level was detected by double antibody sandwich enzyme linked immunosorbent assay（ABC-ELISA） method.Results The percentage of the first second forced expiratory volume in expected value（FEV1% pred） and the percentage of first second forced expiratory volume in forced vital capacity（FEV1/ FVC%） in AECOPD group decreased significantly compared with stable phase group and control group（all P 〈 0.01）,and the percentage of residual volume in expected value（RV% pred）in AECOPD group increased significantly compared with stable phase group and control group（all P 〈 0.01）.FEV1% pred and FEV1/ FVC% in COPD stable phase group decreased significantly compared with control group（all P 〈 0.01）,and RV% pred in COPD stable phase group increased significantly compared with control group（P 〈 0.01）.The serum adiponectin levels in AECOPD group increased significantly compared with stable phase group and control group（all P 〈0.01）,and the serum adiponectin level in stable phase group increased significantly compared with control group（P 〈0.01）.The serum adiponectin levels in AECOPD group and COPD stable phase group were all negatively correlated with FEV1% pred（r =-0.826,r =-0.729,all P 〈 0.01） and FEV1/ FVC%（r =-0.624,r =-0.661,all P 〈 0.01） and positively correlated with RV% pred（r = 0.715,r = 0.902,P 〈 0.01）.Conclusion Adiponectin is involved in the occurrence and development of chronic airway inflammation of COPD and can serve a new marker of inflammation.