血清可溶性转铁蛋白受体水平与慢性阻塞性肺疾病患者认知障碍程度的相关性研究

Correlation between Serum Soluble Transferrin Receptor Level and Severity of Cognitive Disorder in Patients with Chronic Obstructive Pulmonary Disease

背景目前,血清可溶性转铁蛋白受体(sTFR)水平与慢性阻塞性肺疾病(COPD)患者认知障碍的关系尚未完全明确。目的探讨血清sTFR水平与COPD患者认知障碍程度的相关性。方法选取2017年2月-2019年7月在西安交通大学第一附属医院就诊的COPD患者248例作为观察组,另选取同期健康体检者250例作为对照组;另根据贫血程度将COPD患者分为轻度组38例、中度组45例、重度组19例及非贫血组146例。比较对照组、观察组及轻度组、中度组、重度组、非贫血组患者血清sTFR、内皮素1 (ET-1)、铁调节素(hepcidin)、8-羟基脱氧尿苷酸(8-OHdG)、低氧诱导因子1α(HIF-1α)水平及蒙特利尔认知评估量表(MoCA)评分;血清sTFR水平、MoCA评分与COPD患者血清ET-1、hepcidin、8-OHdG、HIF-1α水平间的相关性分析及血清sTFR水平与COPD患者MoCA评分的相关性分析均采用Pearson相关分析。结果 (1)观察组患者血清sTFR、ET-1、hepcidin、8-OHdG、HIF-1α水平高于对照组,MoCA评分低于对照组(P<0.05)。(2)轻度、中度、重度组患者血清sTFR、ET-1、hepcidin、8-OHdG、HIF-1α水平高于非贫血组,MoCA评分低于非贫血组(P<0.05);中度、重度组患者血清sTFR、ET-1、hepcidin、8-OHdG、HIF-1α水平高于轻度组,MoCA评分低于轻度组(P<0.05);重度组患者血清sTFR、ET-1、hepcidin、8-OHdG、HIF-1α水平高于中度组,MoCA评分低于中度组(P<0.05)。(3) Pearson相关分析结果显示,血清sTFR水平与COPD患者血清ET-1 (r=0.482)、hepcidin(r=0.682)、8-OHdG(r=0.513)、HIF-1α(r=0.441)水平均呈正相关(P<0.05),MoCA评分与COPD患者血清ET-1 (r=-0.461)、hepcidin (r=-0.515)、8-OHdG(r=-0.485)、HIF-1α(r=-0.437)水平均呈负相关(P<0.05);血清sTFR水平与COPD患者MoCA评分呈负相关(r=-0.481,P<0.05)。结论随着贫血程度加重,COPD患者血清sTFR水平升高、认知障碍程度加重,且血清sTFR水平与COPD患者认知障碍程度有关。

Background Relationship between serum soluble transferrin receptor(sTFR)level and cognitive disorder in patients with COPD is not completely clear so far. Objective To analyze the correlation between serum sTFR level and severity of cognitive disorder in patients with COPD. Methods A total of 248 patients with COPD were selected as observation group in the First Affiliated Hospital of Xi’an Jiaotong University from February 2017 to July 2019,meanwhile a total of 250 healthy people admitted to this hospital for physical examination were selected as control group;all patients with COPD were divided into mild group(n=38),moderate group(n=45),severe group(n=19)and non-anemia group (n=146)according to the incidence and severity of anemia. Serum levels of s TFR,ET-1,hepcidin,8-OHd G,HIF-1α and Mo CA score were compared between control group and observation group,among mild group,moderate group,severe group and non-anemia group;Pearson correlation analysis was used to analyze the correlations of serum s TFR level and Mo CA score with serum levels of ET-1,hepcidin,8-OHd G,HIF-1α in patients with COPD,as well as between serum s TFR level and Mo CA score in patients with COPD. Results (1)Serum levels of s TFR,ET-1,hepcidin,8-OHd G and HIF-1α in observation group were statistically significantly higher than those in control group,while Mo CA score in observation group was statistically significantly lower than that in control group(P<0.05).(2)Serum levels of s TFR,ET-1,hepcidin,8-OHd G and HIF-1α in mild group,moderate group and severe group were statistically significantly higher than those in non-anemia group,while Mo CA score in mild group,moderate group and severe group was statistically significantly lower than that in non-anemia group,respectively(P<0.05);serum levels of s TFR,ET-1,hepcidin,8-OHd G and HIF-1α in moderate group and severe group were statistically significantly higher than those in mild group,while Mo CA score in moderate group and severe group was statistically significantly lower than that in mild group,respectively(P<0.05);serum levels of s TFR,ET-1,hepcidin,8-OHd G and HIF-1α in severe group were statistically significantly higher than those in moderate group,while Mo CA score in severe group was statistically significantly lower than that in moderate group(P<0.05).(3)Pearson correlation analysis results showed that,serum s TFR level was positively correlated with serum levels of ET-1(r=0.482),hepcidin(r=0.682),8-OHd G(r=0.513)and HIF-1α(r=0.441)in patients with COPD,respectively(P<0.05),while Mo CA score was negatively correlated with serum levels of ET-1(r=-0.461),hepcidin(r=-0.515),8-OHd G(r=-0.485)and HIF-1α(r=-0.437),respectively(P<0.05);serum s TFR level was negatively correlated with Mo CA score in patients with COPD(r=-0.481,P<0.05). Conclusion As severity of anemia aggravates,serum s TFR level increases and severity of cognitive disorder aggravates in patients with COPD,and serum s TFR level is significantly correlated with the severity of cognitive disorder in patients with COPD.