血清微量元素与哮喘-慢性阻塞性肺疾病重叠综合征患者病情严重程度的关系

Relationship between serum trace elements and disease severity in patients with asthma chronic obstructive pulmonary disease overlap syndrome

目的 探讨哮喘-慢性阻塞性肺疾病重叠综合征(ACO)患者血清微量元素与病情严重程度的关系。方法 选择2019年2月至2020年10月新疆医科大学第一附属医院收治的42例ACO患者为研究对象,根据第1秒用力呼气量(FEV1)将患者分为轻中度组(n=17)和重度/极重度组(n=25)。检测患者肺功能指标及呼出气一氧化氮(FeNO)。采用串联质谱法测定患者血清镁、锰、铅、锌、铁、铜等微量元素水平。利用流式细胞仪检测外周血T淋巴细胞亚群。根据慢性阻塞性肺疾病评估测试(CAT)、咳嗽临床症状评分(CCSS)和改良的医学研究理事会呼吸困难量表(mMRC)3份问卷对患者健康状况进行评估。结果 重度/极重度组患者血清镁、FeNO、CD8+低于轻中度组(P<0.05)。重度/极重度组患者CD4+/CD8+、CAT、mMRC(P<0.05)。血清镁分别与FEV1%、FVC、FEV1/FVC、FeNO、CD8+呈正相关,与CD4+/CD8+、CAT、mMRC呈负相关(P<0.05)。与高FeNO患者相比,低FeNO患者血清镁浓度显著降低(P<0.05)。结论 ACO患者血清镁与肺功能、FeNO、T淋巴细胞亚群、健康状况有关,可能成为反映ACO病情严重程度的指标。

Objective To investigate the relationship between serum trace elements,exhaled nitric oxide(FeNO),T lymphocyte subsets and severity of asthma chronic obstructive pulmonary disease overlap syndrome(ACO).Methods 42 elderly patients with ACO from the hospital were selected as the research object.According to FEV1,the patients were divided into mild and moderate groups and severe groups.Pulmonary function indexs and FeNO were measured.The serum trace element level and peripheral blood T-lymphocyte subsets were measured.The health status of the patients were evaluated by 3 questionnaires.Results Serum magnesium,FeNO and CD8+in severe/extremely severe group were lower thanthose in mild and moderate group(P<0.05).CD4+/CD8+,CAT,mMRC in severe/extremely severe group(P<0.05).Serum magnesium was positively correlated with FEV1%,FVC,FEV1/FVC,FeNO,CD8+,but it negatively correlated with CD4+/CD8+,CAT,mMRC(P<0.05).Compared with high FeNO group,the serum magnesium concentration in the low FeNO group was significantly lower(P<0.05).Conclusion Serum magnesium in patients with ACO is related to lung function,FeNO,T lymphocyte subsets and health status,which may be an indicator of the severity of ACO.