激活素A与COPD稳定期患者营养状况及肺功能的关系

The correlations between Activin A and lung function or nutritional status in stable chronic obstructive pulmonary disease patients

目的探讨激活素A与慢性阻塞性肺疾病(COPD)稳定期患者营养状况及肺功能变化的关系。方法检测200例COPD稳定期患者(COPD组)和100例体检健康者(对照组)血清激活素A浓度;所有受试者均需完成肺功能检查和微型营养评定(MNA)问卷。根据肺功能将COPD患者分为轻-中度亚组、重-极重度亚组;根据MNA评分将COPD患者分为营养良好亚组和营养不良(风险)亚组。结果对照组与COPD组性别构成比、吸烟指数、年龄之间差异无统计学意义(P>0.05);COPD组患者肺功能第1秒用力呼气量(FEV_1)占预计值百分比(FEV1%)、FEV_1与用力肺活量(FVC)比值(FEV_1/FVC)、MNA得分均低于对照组,而血清激活素A水平均高于对照组,差异有统计学意义(P<0.05)。COPD患者轻-中度亚组、重-极重度亚组血清激活素A水平高于对照组,重-极重度亚组血清激活素A水平高于轻-中度亚组,差异均有统计学意义(P<0.05)。与对照组相比,COPD患者营养良好亚组、营养不良(风险)亚组血清激活素A水平升高;与营养良好亚组比较,营养不良(风险)亚组血清激活素A水平升高,差异均有统计学意义(P<0.05)。相关性分析:COPD稳定期患者血清激活素A水平与FEV1%、FEV1/FVC、MNA得分均呈负相关(r=-0.43、-0.398、-0.229,P<0.05)。结论激活素A与COPD患者营养状况及肺功能变化相关,激活素A可能参与COPD患者营养不良及气流受限的发展过程。

Objective To investigate the correlations of serum Activin A level with the nutritional status and the lung function in stable chronic obstructive pulmonary disease （ COPD ） patients. Methods Data of 200 patients with COPD （COPD group） and 100 healthy persons （control group） were collected. The results of mini nutritional assessment （MNA） were performed, and the lung function were tested. In the COPD group, patients with the Class Ⅰ - Ⅱ lung function were assigned into the mild - moderate subgroup and as the Class Ⅲ- Ⅳ paitents were assigned into the severe - very severe subgroup. Nutritional status was assessed by MNA. Results There was no significant difference in age, gen- der or smoking index between COPD group and control group （P 〉 0. 05 ）. Compared with control group, FEV1 %, FEV1/ FVC% and MNA values were significantly reduced and Activin A serum level was increased significantly in the COPD group （ P 〈 0. 05 ）. Compared with control group, the serum level of Activin A were significantly increased in mild - mod- erate subgroup and severe -very severe subgroup. Compared with the mild -moderate subgroup, the Activin A level was significantly increased in severe - very severe subgroup （ P 〈 0. 05 ）. In control group, the level of Activin A in serum were significantly reduced compared with COPD group; and compared with malnourished （risk） COPD subgroup, the level of Activin A in serum was significantly reduced in well - nourished COPD subgroup （ P 〈 0. 05）. The Activin A level was significantly negatively correlated with FEVt % and MNA in COPD patients （r = -0. 43 and -0. 229, P 〈 0. 05 ）. Con- clusion The Activin A is associated with nutritional status and pulmonary function in patients with COPD, and Activin A may be involved in the development of malnutrition and airflow limitation in patients with COPD.