维生素D与COPD患者肺功能及血清炎症因子的相关性

Association of vitamin D with pulmonary function and serum inflammatory factors in COPD

目的:探讨维生素D与慢性阻塞性肺疾病(COPD)患者肺功能及血清炎症因子之间的关系。方法:收集健康体检者27例,COPD稳定期患者30例,COPD急性加重期患者34例,分别采用电化学发光法测定25-羟基维生素D[25-(OH)D],ELISA法测定INF-γ、TNF-α,流式细胞技术测定IL-2、IL-4、IL-6、IL-10,比较3组受试者上述指标水平的差异,同时测定3组受试者的第一秒用力呼气容积(FEV1),分别探讨COPD稳定期组和COPD急性加重期组患者血清25-(OH)D与FEV1、INF-γ、TNF-α、IL-2、IL-4、IL-6、IL-10之间的关系。结果:3组患者的血清25-(OH)D水平比较,COPD急性加重期组和COPD稳定期组均低于健康体检组(P<0.001),COPD急性加重期组低于COPD稳定期组(P<0.001)。3组的维生素D缺乏患病率比较,COPD急性加重期组与COPD稳定期组均高于健康体检组(P<0.001),而COPD急性加重期组与COPD稳定期组的患病率差异无统计学意义(P=0.225)。COPD稳定期组的血清25-(OH)D水平与FEV1水平呈正相关(r=0.524,P=0.005)。COPD急性加重期组的血清INF-γ水平较COPD稳定期组高(P<0.001);COPD急性加重期组INF-γ及IL-6水平均较健康体检组高(均P<0.001);COPD稳定期组IL-2及IL-6水平较健康体检组高(P=0.024和P=0.007)。COPD患者血清25-(OH)D水平与INF-γ、TNF-α和IL-2、IL-4、IL-6、IL-10之间无线性相关性。结论:COPD患者的维生素D缺乏患病率较健康人高,维生素D水平可能与FEV1水平存在正相关,而COPD患者血清25-(OH)D水平与血清炎症因子水平无线性相关性。

Objective： To investigate the relationship between vitamin D and pulmonary function and serum inflammatory factors in patients with COPD. Methods： Twenty-seven healthy subjects, 30 patients with stable COPD and 34 patients with acute exacerbations of COPD were enrolled in our study. Serum level of 25- （OH）D was measured by the ECLIA. The expression of INF-~, and TNF-ct were measured by ELISA, and IL- 2, IL-4, IL-6, IL-10 were measured by FCM. All these subjects were compared among three groups. All patients of three groups performed pulmonary function tests. Correlations between 25-（OH）D and FEV1, INF-7, TNF-a and IL-2, IL-4, IL-6, IL-10 were analyzed in stable COPD group and AECOPD group. Results： OThe levels of 25-（OH）D in AECOPD group and stable COPD group were significantly lower than those in control group （P〈0.001）. The level of 25-（OH）D in AECOPD group was significantly lower than that in stable COPD group （P〈0.001）. The prevalence of Vitamin D deficiency of AECOPD group and stable COPD group were higher than that of the control group （P〈0.001）, but there was no significant difference between AECOPD group and stable COPD （P=-0.225）. The level of 25-（OH） D was positively correlated with FEV1 in stable COPD group （r=0.524, P=-0.005）. The level of INF-yofAECOPD group was significantly higher than those in stable COPD group （P〈0.001）. The level of INF-y and IL-6 of AECOPD group was significantly higher than those in control group （both P〈0.001）. The level of IL-2 and IL-6 of stable COPD group was significantly higher than those in control group （P=0.024, P=0.007, respectively）. There was no linear correlation between the level of 25-（OH） D and INF-y, TNF-a IL-2, IL-4, IL-6, IL-10 in patients with COPD. Conclusion： Vitamin D deficiency is highly prevalent to COPD patients, and the level of 25-（OH） D may be positively correlated with FEV1, but there was no linear correlation between the level of 25-（OH） D and serum inflammatory factors in patients with COPD.