血清总Ⅰ型氨基末端延长肽和维生素D3对慢性阻塞性肺疾病患者罹患骨质疏松诊断价值分析

The diagnostic value analysis on serum total type ] amino terminal extension of the peptide and vitamin D3 in chronic obstructive pulmonary disease patients suffered from osteoporosis

目的探讨慢性阻塞性肺疾病（COPD）患者血清总Ⅰ型氨基末端延长肽和维生素D，及吸烟指数与骨质疏松的关系。方法选取150例COPD患者（试验组）和同期150例健康对照者（对照组）为研究对象，采用电化学发光法检测总Ⅰ型氨基末端延长肽，酶联免疫法测定维生素D3。根据病情将150例COPD患者分为轻度组（45例）、中度组（52例）、重度组（53例）；150例COPD患者中120例吸烟，依据吸烟指数分成三组：A组吸烟指数小于360支·年，36例；B组吸烟指数360～400支·年，34例；C组吸烟指数401～560支·年，50例。比较各组血清总Ⅰ型氨基末端延长肽和维生素D，水平，并进行相关性分析。结果试验组血清维生素D3和总Ⅰ型氨基末端延长肽均显著低于对照组[（35．37±12．11）mg／L比（45．88±12．55）mg／L、（38．16±11．12）mg／L比（45．23±12．33）mg／L]，差异有统计学意义（f=2．74和4．64，P〈0．01）；轻度组、中度组、重度组COPD患者血清维生素D1、总I型氨基末端延长肽依次递减，血清总Ⅰ型氨基末端延长肽和维生素D3水平与COPD严重程度呈正相关（r=0．185和0．257，P〈0．05）。A、B、C组血清维生素D3、总I型氨基末端延长肽依次递减，血清总Ⅰ型氨基末端延长肽和维生素D3水平与吸烟指数呈正相关（r=0．159和0．172，P〈0．05）。结论COPD患者较健康人群容易罹患骨质疏松，血清总Ⅰ型氨基末端延长肽和维生素D3可以预测COPD患者骨质疏松情况。

Objective To explore the relationship between osteoporosis and serum total typeⅠ amino terminal extension of the peptide, vitamin D3 and smoking index in the patients with chronic obstructive pulmonary disease （COPD）. Methods One hundred and fifty patients with COPD （test group） and 150 healthy people （control group） were selected. The total type Ⅰ amino terminal extension of the peptide was measured by electrochemical luminescence, and enzyme-linked immunoassay was adopted to determine the vitamin D3. The 150 patients with COPD were divided into slight group （45 cases）, moderate group （52 cases） and severe group （53 cases） according to the severity of COPD. In 150 patients with COPD, 120 patients with smoking were divided into 3 groups according to smoking index： A group smoking index 〈 360, 36 cases; B group smoking index 360 -400, 34 cases; and C group smoking index 401 - 560, 50 cases. The levels of serum total type I amino terminal extension of the peptide and vitamin D3 were compared and correlation was analyzed. Results The vitamin D3 and the total type I amino terminal extension of the peptide levels in test group were significantly lower than those in control group： （35.37 ± 12.11） mg/L vs. （45.88 ± 12.55） mg/L and （38.16 ± 11.12） mg/L vs. （45.23 ± 12.33） mg/L, and there were statistical differences （t = 2.74 and 4.64, P〈 0.01）. The levels of vitamin D3 and the total type Ⅰ amino terminal extension of the peptide in slight, moderate and severe group were decreased in turn, and the levels of total type Ⅰ amino terminal extension of the peptide and the vitamin D3 were positively associated with the severity of COPD （r = 0.185 and 0.257, P 〈 0.05）. The levels of vitamin D3 and total type Ⅰ amino terminal extension of the peptide in A, B and C group were decreased in turn, and the levels of total type I amino terminal extension of the peptide and the vitamin D3 were positively associated with smoking index （r = 0.159 and 0.172, P 〈 0.05）. Conclusion COPD patients are easier to suffer from osteoporosis compared with healthy population, and the serum vitamin D3 and total type Ⅰ amino terminal extension of the peptide can forecast the osteoporosis in COPD patients.