血清维生素D水平与COPD患者的生活质量及COPD有关炎症因子的相关性研究

Study on the correlation between vitamin D and quality of life,COPD related inflammatory factor in patients with COPD

目的观察和分析血清维生素D水平与慢性阻塞性肺疾病(COPD)患者的生活质量及COPD相关炎症因子的相关性。方法选取50例慢性阻塞性肺疾病急性发作(AECOPD)患者作为AECOPD组,选取50例COPD稳定期患者作为COPD稳定期组,另选取50例健康人作为对照组,对三组研究对象的血清25-羟基维生素D(25-(OH)D)水平、干扰素-γ(INF-γ)水平和白细胞介素-17(IL-17)水平进行检测和比较;对AECOPD组和COPD稳定期组患者的COPD评估测试(CAT)问卷评分情况进行评价和比较。结果对照组的血清25-(OH)D水平显著高于其它两组(P<0.05),维生素D缺乏患病率显著低于其它两组(P<0.05),COPD稳定期组患者的血清25-(OH)D水平显著高于AECOPD组(P<0.05),AECOPD组患者的血清INF-γ水平、血清IL-17水平显著高于COPD稳定期组,且COPD稳定期组患者的上述血清炎症因子水平显著高于对照组(P<0.05);AECOPD组患者的CAT评分显著高于COPD稳定期组(P<0.05),Pearson直线相关分析结果显示,COPD患者的血清25-(OH)D水平与CAT评分(r=-0.604)、血清INF-γ水平(r=-0.685)、血清IL-17水平(r=-0.718)均呈负相关关系(P<0.05),多元线性回归结果显示,COPD患者的CAT评分与血清25-(OH)D水平(r=-0.672)、血清INF-γ水平(r=0.582)、血清IL-17水平(r=0.494)均具有相关性(P<0.05)。结论 COPD患者表现血清维生素D水平、生活质量的下降和炎症反应的加剧,AECOPD患者的上述变化更加显著。COPD患者的血清维生素D水平与其生活质量和炎症因子水平具有相关性,可用于辅助评价患者的病情,临床医生应把握其相关性、及时采取有效的干预措施,从而达到提高患者生活质量、延缓疾病进展、改善患者预后的目的。

Objective To observe and analyze the correlation between vitamin D and quality of life,chronic obstructive pulmonary disease（ COPD） related Inflammatory factor in patients with COPD. Methods 50 patients with acute exacerbation of chronic obstructive pulmonary disease（ AECOPD） were selected as the AECOPD group,50 patients in stable phase of COPD were selected as the stable phase COPD group,and50 healthy people were selected as the control group. The serum 25 hydroxy vitamin D（ 25-（ OH） D） level,interferon- γ（ INF- γ） level and interleukin- 17（ IL- 17） level of the objects in the three groups were detected and compared; The COPD assessment test（ CAT） questionnaire scores of the patients in the AECOPD group and the stable phase COPD group were evaluated and compared. Results The serum 25-（ OH） D level of the objects in the control group was significantly higher than that of the other two groups（ P〈0. 05）,the prevalence of vitamin D deficiency was significantly lower than that of the other two groups（ χ2= 17. 825,7. 484,P〈0. 05）. The serum 25-（ OH） D level of the patients in the stable phase COPD group was significantly higher than that in the AECOPD group（ P〈0. 05）. The serum INF- γ level and IL- 17 level of the patients in the AECOPD group were significantly higher than those in the stable phase COPD group and those in the stable phase COPD group were significantly higher than those in the control group（ P〈0. 05）. The CAT score of the patients in the AECOPD group was significantly higher than that in the stable phase COPD group（ t = 5. 026,P〈0. 05）. Pearson correlation analysis showed the serum 25-（ OH） D level of the patients with COPD was negatively correlated with the CAT score（ r =- 0. 604）,the serum INF- γ level（ r =- 0. 685） and the serum IL- 17 level（ r =- 0. 718）（ P〈0. 05）. The multiple linear regression analysis showed that the CAT score of the patients with COPD was correlated with the serum 25-（ OH） D level（ r =- 0. 672）,the serum INF- γ level（ r = 0. 582） and of the serum IL- 17 level（ r = 0. 494）（P〈0. 05）. Conclusion The patients with COPD show the decrease of the serum vitamin D level,quality of life and the intensified inflammatory reaction. The above changes in patients with AECOPD are more significant. The serum vitamin D level in patients with COPD is associated with quality of life and the level of inflammatory factors,and can be used to assist the evaluation of the disease. The clinicians should acknowledge such relevance,take timely and effective intervention measures,so as to improve the quality of life of the patients,delay the progression of the disease and improve the prognosis of the patients.