AECOPD患者营养状况、氧化应激水平及与肺功能的相关性分析

Nutritional Status and Oxidative Stress Level in Patients with AECOPD and Their Correlation with Lung Function

目的分析慢性阻塞性肺疾病急性加重期(AECOPD)患者的营养状况、氧化应激水平及与其肺功能的相关性。方法选取2014年5月-2019年5月我院收治的慢性阻塞性肺疾病(COPD)患者156例为研究对象,根据患者病情状况分为稳定组和急性加重组,每组78例,再选取同期56例健康体检者作为正常组。检测并比较3组肺功能、氧化应激水平,并对所有纳入者的营养状况进行评估。结果与正常组比较,稳定组和急性加重组患者体质量指数、肱三头肌皮褶厚度、上臂肌围、血清前白蛋白,血清白蛋白、淋巴细胞计数均显著降低,急性加重组低于稳定组(P<0.05)。与正常组比较,急性加重组和稳定组血小板活化因子(PAF)、P-选择蛋白(CD62P)均显著增高,且急性加重组高于稳定组(P<0.05);超氧化物歧化酶(SOD)、谷胱甘肽过氧化物酶(GSH-Px)水平显著减低,且急性加重组低于稳定组(P<0.05)。急性加重组患者第1秒用力呼气容积占预计值的百分比、第1秒用力呼气容积占用力肺活量比例均显著低于稳定组和正常组(P<0.05)。AECOPD的肺功能水平与患者营养状况、SOD、GSH-Px呈正相关,与PAF、CD62P指标呈负相关。结论 AECOPD患者的肺功能情况与患者氧化应激水平及营养状况密切相关,对患者营养状态进行干预,可有效改善患者肺功能和氧化应激水平。

Objective To analyze the nutritional status and oxidative stress level of patients with acute exacerbation of chronic obstructive pulmonary disease(AECOPD) and their correlation with lung function. Methods A total of 156 patients with chronic obstructive pulmonary disease(COPD) admitted to our hospital from May 2014 to May 2019 were enrolled in the study. According to the patient’s condition, they were divided into the stable group and acute exacerbation group, with 78 cases in each group, and 56 healthy people who underwent physical examination during the same period were selected as the normal group. The lung function and oxidative stress levels of the three groups were detected and the nutritional status of all patients was evaluated. Results Compared with those in normal group, the body mass index, skin fold thickness of triceps brachii, upper arm circumference, serum prealbumin, serum albumin and lymphocyte count were decreased in the stable group and exacerbation group, and the above indicators in the acute exacerbation group were significantly lower than those in the stable group(P<0.05). Compared with the normal group, platelet activating factor(PAF) and P-selectin(CD62 P) in the acute exacerbation group and the stable group were significantly higher, which were higher in acute exacerbation group than in the stable group(P<0.05). In addition, the levels of SOD and GSH PX were significantly reduced, which were significantly lower in the acute exacerbation group than in the stable group(P<0.05). The percentage of forced expiratory volume in the first second and the proportion of forced expiratory volume in the first second were significantly lower in the acute exacerbation group than in the stable group and the normal group(P<0.05). The lung function of patients with AECOPD was positively correlated with nutritional status, SOD and GSH Px, and negatively correlated with PAF and CD62 p. Conclusion he lung function of patients with AECOPD is closely related to the oxidative stress level and nutritional status of patients. Therefore, intervention of nutritional status of patients can effectively improve the lung function and oxidative stress level of patients.