职业性哮喘患者动脉粥样硬化相关指标的变化及临床意义

Changes and clinical significance of atherosclerosis related indexes in patients with occupational asthma

目的观察职业性哮喘(OA)患者的动脉粥样硬化(AS)相关指标的变化。方法2017年7月-2018年6月以102例OA患者为病例组(根据病程和病情程度分为轻度<5年亚组、轻度≥5年亚组、中重度<5年亚组、中重度≥5年亚组),以30名健康成年人为对照组,应用彩色多普勒超声、动脉硬化检测仪、生化检测仪等检测总胆固醇(TC)、三酰甘油(TG)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)、C反应蛋白(CRP)、同型半胱氨酸(HCY)、血尿酸(UA)、糖化血红蛋白(HbA1c)、颈动脉内膜中层厚度(IMT)和踝臂指数(ABI)等指标。结果炎性因子等指标:与对照组比较,病例组4个亚组CRP均升高,除轻度<5年亚组外,其余3个亚组TC、LDL-C、TG和HCY均升高,HDL-C均下降;亚组之间重病情或长病程组TC、LDL-C、TG和CRP升高,HDL-C降低,上述差异均有统计学意义(均P<0.05)。AS指标:与对照组比较,轻度≥5年亚组、中重度2个亚组IMT及IMT异常率均升高,中重度2个亚组ABI均降低;亚组之间重病情或长病程组IMT升高,上述差异均有统计学意义(均P<0.05)。结论OA患者AS相关指标升高或异常,并随病程的延长和病情的加重而加重。

Objective To observe the changes of atherosclerosis related indexes in patients with occupational asthma(OA).Methods From July 2017 to June 2018,102 OA patients were selected as the case group(they were divided into mild<5 years subgroup,mild≥5 years subgroup,moderate-severe<5 years subgroup and moderate-severe≥5 years subgroup according to the course and severity of disease),while 30 healthy adults served as control group.Color Doppler ultrasound,arteriosclerosis detector and biochemical detector were used to test the total cholesterol(TC),triglyceride(TG),high density lipoprotein cholesterol(HDL-C),C-reactive protein(CRP),homocysteine(Hcy),serum uric acid(UA),glycosylated hemoglobin(HbA1 c),carotid intima-media thickness(IMT)and ankle brachial index(ABI).Results Inflammatory cytokine and other indexes:Compared with the control group,CRP level in the four subgroups of the case group were increased.Except for the mild<5 year subgroup,the levels of TC,LDL-C,TG and HCY in the other three subgroups were increased,while HDL-C levels were decreased.Among subgroups,the levels of TC,LDL-C,TG and CRP in severe illness or long course groups were increase,while HDL-C levels were decreased.All differences were statistically significant(P<0.05).Atherosclerosis indexes:Compared to the control group,IMT level and IMT abnormal rate in mild≥5 years subgroup and two moderate-severe subgroups were increased,while ABI level in two moderate-severe subgroups were decreased.Among subgroups,IMT level in severe illness or long course groups were increased.All differences were statistically significant(P<0.05).Conclusion The atherosclerosis related indexes in patients with OA are increased or abnormal,and aggravated with the extension of course and severity of illness.