慢性阻塞性肺疾病患者血清视黄醇结合蛋白4水平及其与营养状况关系

目的了解慢性阻塞性肺疾病（COPD）患者血清视黄醇结合蛋白4（RBP-4）水平及其与营养状况的关系，探讨其临床意义。方法采用酶联免疫吸附测定法（ELISA）检测62例COPD稳定期患者和20例健康对照者血清RBP-4水平，分析其相关因素。结果COPD组血清RBP-4水平显著低于健康对照组（P〈0．01）；其中COPD营养不良组降低更显著（P〈0．01）；COPD营养正常组较健康对照组也显著降低（P〈0．01）。多元逐步回归分析表明，体质指数（BMI）和上臂肌围（MAMC）是血清RBP-4的独立相关因素。结论COPD稳定期患者血清RBP-4水平下降，营养状况越差降低越显著；营养正常的COPD患者血清RBP-4水平亦降低，提示这种改变并非均由营养不良引起，可能与疾病本身有关。

Serum Retinol Binding Protein-4 Level in Patients with Chronic Obstructive Pulmonary Disease and its Rela-tionship to Nutritional Status

Objective To determine the serum retinol binding protein-4 level in patients with chronic obstructive pulmonary disease(COPD)and investigate its relationship to nutritional status and its clinical significance.Methods The serum retinol binding protein-4 lev-el in 62 stable COPD patients and 20 healthy controls was measured by enzyme-linked immunosorbent assay(ELISA).Correlated factors of serum retinol binding protein-4 were analyzed.Results The resum retinol binding protein-4 level was significantly lower in COPD patients than in the healthy controls(P < 0.01),especially lower in COPD patients with malnutrition(P < 0.01).The serum retinol binding protein-4 level in COPD patients without malnutrition was still significantly lower than in the healthy control(sP < 0.01).In a multiple stepwise regres-sion analysis,body mass index(BMI)and mid-upper arm muscle circumference(MAMC)were independent influencing factors of RBP-4.Conclusion The serum RBP-4 level in stable COPD patients is significantly lower,especially in patients with malnutrition.The serum RBP-4 level still significantly decreases in COPD patients without malnutrition.It suggests that this change is not completely due to malnutri-tion and may be associated with COPD.