重症哮喘患者血脂组分与体重指数、肺功能及气道炎症的相关性研究

Relationship of blood lipid components with body mass index,lung function and airway inflammation in children with severe asthma

目的 探讨重症哮喘患者血脂组分与体重指数、肺功能和气道炎症的关系。方法 选择113例重症哮喘患者为研究对象,入院后抽取肘静脉血约5 mL,采用气相色谱-质谱法检测血浆中23种脂肪酸的表达水平。同时,检测患者肺功能及呼出气一氧化氮(FeNO)水平,统计分析重症哮喘患者血脂组分与肺功能的相关性。结果 (1)气相色谱-质谱鉴定结果显示,饱和脂肪酸约占血浆总脂肪酸的50.5%,主要是十六烷酸(72.1%)和硬脂酸(22.3%);其次是单不饱和脂肪酸(17.3%)。血浆ω-3脂肪酸和ω-6脂肪酸水平之间存在不平衡,ω-6脂肪酸占血浆总脂肪酸的30.4%,而ω-3仅占1.9%。(2)相关性分析结果显示,血浆总脂肪酸(r=-0.284,P=0.032)、总单不饱和脂肪酸(r=-0.263,P=0.035)、总多不饱和脂肪酸(r=-0.252,P=0.043)、总ω-6脂肪酸(r=-0.258,P=0.042)均与PEF_(25%-75%)呈负相关关系。血浆总脂肪酸(r=-0.296,P=0.034)、总单不饱和脂肪酸(r=-0.257,P=0.043)与FEV_(1)呈负相关关系。血浆总脂肪酸(r=0.448,P=0.039)、总单不饱和脂肪酸(r=0.369,P=0.021)、总多不饱和脂肪酸(r=0.172,P=0.041)表达水平与FeNO呈正相关关系。(3)多因素分析显示,油酸、十六烷酸、硬脂酸、血浆总脂肪酸、总单不饱和脂肪酸、总饱和脂肪酸、花生四烯酸(AA)/十二碳五烯酸(EPA)比值是影响患者FEV_(1)的独立危险因素;总单不饱和脂肪酸、血浆总脂肪酸、AA/EPA比值是影响患者PEF_(25%-75%)的独立危险因素;二十二烷酸、神经酸、油酸、总单不饱和脂肪酸是影响患者FeNO的独立危险因素。结论 重症哮喘患者血浆总脂肪酸、单不饱和脂肪酸及多不饱和脂肪酸表达水平与患者肺功能有明显相关性,可作为疾病控制程度的参考指标。

Objective To investigate the relationship between blood lipid components and body mass index,lung function,and airway inflammation in patients with severe asthma.Methods 113 patients with severe asthma were selected as the research subjects.After admission,5ml of elbow vein blood was extracted from the patient,and the expression levels of 23 fatty acids in the plasma were detected using gas chromatography-mass spectrometry.Detect the lung function and fractional exhaled nitric oxide(FeNO) levels of patients.Analyze the correlation between blood lipid components and lung function in patients with severe asthma.Results(1) The identification results of gas chromatography-mass spectrometry showed that saturated fatty acids accounted for about 50.5% of the total fatty acids in plasma(72.1% were hexadecane acids and 22.3% were stearic acids),followed by monounsaturated fatty acids(17.3%).There is an imbalance between the levels of ω-3 fatty acids and ω-6 fatty acids in plasma.ω-6 fatty acids account for 30.4% of total plasma fatty acids,while ω-3 fatty acids account for 1.9%.(2) The correlation analysis results show that plasma total fatty acids(r=-0.284,P=0.032),total monounsaturated fatty acids(r=-0.263,P=0.035),total polyunsaturated fatty acids(r=-0.252,P=0.043),total ω-6 fatty acids(r=-0.258,P=0.042) were negatively correlated with PEF_(25%-75%).There was a negative correlation between plasma total fatty acids( r =-0.296,P = 0.034),total monounsaturated fatty acids( r =-0.257,P = 0.043),and FEV1.The expression levels of plasma total fatty acids( r = 0.448,P = 0.039),total monounsaturated fatty acids( r= 0.369,P = 0.021),and total polyunsaturated fatty acids( r = 0.172,P = 0.041) were positively correlated with Fe NO.( 3) Multivariate analysis showed that oleic acid,hexadecane acid,stearic acid,total plasma fatty acids,total monounsaturated fatty acids,total saturated fatty acids,and the ratio of arachidonic acid( AA)/eicosapentaenoic Acid( EPA) were independent risk factors affecting FEV1in patients;total monounsaturated fatty acids,plasma total fatty acids,and AA/EPA ratio were independent risk factors affecting PEF25%-75%in patients;docosanoic acid,citric acid,oleic acid,and total monounsaturated fatty acids were independent risk factors affecting Fe NO in patients.Conclusion The expression levels of plasma total fatty acids,monounsaturated fatty acids,and polyunsaturated fatty acids in severe asthma patients are significantly correlated with lung function,and can be used as reference indicators for disease control.