脂联素与慢性阻塞性肺疾病急性加重期患者炎性标志物、营养状态及后期重度急性加重次数的相关性研究

Correlation study between adiponectin and inflammatory markers,nutritional status and severe acute exacerbation in patients with acute exacerbation of chronic obstructive pulmonary disease

目的:探讨慢性阻塞性肺疾病急性加重期(AECOPD)患者血清脂联素与炎性标志物、营养状态及重度急性加重次数的关系。方法:选取2017年7月至2019年4月上海市宝山区吴淞中心医院AECOPD男性患者163例,根据血清脂联素水平将患者分为低脂联素组(血清脂联素≤102.38μg/L,97例)和高脂联素组(血清脂联素>102.38μg/L,66例),比较两组白细胞介素(IL)-6、IL-8、红细胞沉降率(ESR)、C反应蛋白(CRP)、血红蛋白、白蛋白、前白蛋白、体质量指数(BMI)及随访1年重度急性加重次数,分析脂联素与炎性标志物、营养状态及1年内重度急性加重次数的关系。结果:低脂联素组BMI、血红蛋白、前白蛋白和白蛋白明显高于高脂联素组[(23.20±3.26)kg/m 2比(20.77±3.78)kg/m 2、(133.23±17.13)g/L比(125.68±20.83)g/L、(185.36±57.60)g/L比(148.83±64.79)g/L、(37.09±4.06)g/L比(33.77±5.86)g/L],差异有统计学意义(P<0.01或P<0.05);两组总蛋白、IL-6、IL-8、CRP和ESR比较差异无统计学意义(P>0.05)。脂联素与BMI、血红蛋白、白蛋白和前白蛋白呈负相关(r=-0.42、-0.28、-0.33和-0.31,P<0.01),与IL-6、IL-8、ESR、CRP无相关性(P>0.05)。低脂联素组随访1年重度急性加重≥4次率明显低于高脂联素组[8.25%(8/97)比22.73%(15/66)],差异有统计学意义(χ2=6.79,P<0.05)。结论:低脂联素AECOPD患者营养状态好,重度急性加重次数少。血清脂联素可作为AECOPD患者重度急性加重的预测指标。

Objective:To investigate the correlation between serum adiponectin(APN)and inflammatory markers,nutritional status and severe acute exacerbation in late stage in patients with acute exacerbation of chronic obstructive pulmonary disease(AECOPD).Methods:One hundred and sixty-three male patients with AECOPD from July 2017 to April 2019 in Wusong Hospital of Baoshan District,Shanghai City were selected.The patients were divided into low APN group(serum APN≤102.38μg/L,97 cases)and high APN group(serum APN>102.38μg/L,66 cases).The interleukin(IL)-6,IL-8,erythrocyte sedimentation rate(ESR),C-reactive protein(CRP),hemoglobin,albumin,prealbumin,body mass index(BMI)and number of severe acute exacerbation in 1 year′follow-up were compared between 2 groups,and the correlation between APN and inflammatory markers,nutritional status and number of severe acute exacerbation were analyzed.Results:The BMI,hemoglobin,prealbumin and albumin in low APN group were significantly higher than those in high APN group:(23.20±3.26)kg/m 2 vs.(20.77±3.78)kg/m 2,(133.23±17.13)g/L vs.(125.68±20.83)g/L,(185.36±57.60)g/L vs.(148.83±64.79)g/L,(37.09±4.06)g/L vs.(33.77±5.86)g/L,and there were statistical differences(P<0.01 or<0.05);there were no statistical differences in total protein,IL-6,IL-8,CRP and ESR between 2 groups(P>0.05).APN showed negative correlation with BMI,hemoglobin,albumin and prealbumin(r=-0.42,-0.28,-0.33 and-0.31;P<0.01);there was no correlation with IL-6,IL-8,ESR and CRP(P>0.05).The rate of 4 times of severe acute exacerbation in 1 year′follow-up in low APN group was significantly lower than that in high APN group:8.25%(8/97)vs.22.73%(15/66),and there was statistical difference(χ^2=6.79,P<0.05).Conclusions:The AECOPD patients with low APN have better nutritional status and less exacerbation.Serum APN can be used as a predictive index of severe acute exacerbation in AECOPD patients.