血脂代谢对COPD频繁急性加重表型的影响

Effects of blood lipid metabolism on acute exacerbation of chronic obstructive pulmonary disease

目的 了解血脂代谢对慢性阻塞性肺疾病(COPD)频繁急性加重表型的影响.方法 146名COPD患者根据1a内急性加重事件的发生频率分为频繁加重组(加重次数≥2)和非频繁加重组(加重次数<2),分析体质指数(BMI)、血脂、COPD评估测试量表(CAT)、改良英国医学研究理事会呼吸困难指数(mMRC)、COPD综合评估、FEV1%pred与频繁急性加重表型的相关性.结果 频繁加重组CAT、mMRC、综合评估高于非频繁加重组(P<0.01),FEV1%pred、总胆固醇、低密度脂蛋白低于非频繁加重组(P<0.01或0.05).总胆固醇、COPD综合评估对频繁加重有显著影响,其中总胆固醇为保护因素(P<0.05)、综合评估为危险因素(P<0.01).结论 血清胆固醇水平可能是COPD频繁急性加重表型保护因素.

Objective To study the effect of blood lipid metabolism on frequent acute exacerbation phenotype of chronic obstructive pulmonary disease(COPD). Methods Based on frequency of acute exacerbation during 1 year, 146 COPD patients were divided into frequent exacerbation(frequency ≥ 2) and infrequent exacerbation(frequency <2) groups. The relationship between frequent acute exacerbation phenotype of COPD and body mass index, serum lipids, COPD Assessment Test(CAT), mMRC, COPD comprehensive evaluation and FEV1%pred was analyzed. Results Compared with infrequent exacerbation group, CAT, mMRC, and comprehensive evaluation were higher(P<0.01), while FEV1%pred, total cholesterol(TC), and low-density lipoprotein were lower in frequent exacerbation group(P<0.01 or 0.05). TC and comprehensive evaluation had significant effects on the frequency of acute exacerbation, of which TC was protective(P<0.05) and comprehensive evaluation was dangerous(P< 0.01). Conclusion Serum TC level might be protective for frequent acute exacerbation phenotype of COPD.