慢性阻塞性肺疾病的炎症反应与体重指数密切相关

目的探讨COPD患者局部及全身炎症反应与体重指数（BMI）的关系。方法2007年9月～2009年2月在我院就诊的稳定期COPD患者74例和健康体检者（对照组）30例。常规行肺功能、动脉血气分析及诱导痰炎症细胞分类计数，ELISA法测定血清C反应蛋白（CRP）、自细胞介素-8（IL-8）、IL_6、IL一10与肿瘤坏死因子-α（TNF-α）。分析以上各指标与BMI之间的关节。结果低体重组COPD患者诱导痰细胞总数与中性粒细胞计数明显高于正常体重组与对照组（P〈0．05）。低体重组COPD患者第一秒用力呼气量占预计值％（FEV1％）、PEV1与用力肺活量（FVC）比值及动脉血氧分压（PaO2）明显低于正常体重组（P〈0．05），动脉血二氧化碳分压（PaC02）明显高于正常体重组（P〈0．05）。低体重组COPD患者BMI与诱导痰细胞总数、中性粒细胞数、CRP、IL-8、IL-及TNF-α呈负相关，相关系数分别为-0．515，-0．468，-0．453，-0．394，-0．462，-0．497，均P〈0．05。结论稳定期COPD患者的气道和全身炎症反应与BMI密切相关。

Study on the relationship between inflammation and malnutritiom in patients with chronic obstructive pulmonary disease

Objective To explore the relationship between inflammation and malnutrition in patients with stable COPD. Methods A total of 74 patients with stable COPD and 30 healthy subjects were recruited into the study. All the patients were divided into the lower body mass index （BMI） group （ BMI 〈 18.5 kg/m2 ） and normal BMI （ BMI = 18.5 - 23.9 kg/m2 ）, lung function, arterial blood gall, cell differentials in induced sputum, and the levels of serium C-reactive protein（CRP） , IL-8, IL-6, IL-10 and TNF-α were determined. Results The incidence of lower BMI with COPD were 37.8%. The levels of total cell count and neutrophils in induced sputum in the lower BMI group were significantly higher than those in the normal BMI group and healthy subjects （P 〈 O. 05 ）. The level of serium CRP, IL-8, TNF-α were significantly higher than those in the normal BMI group with COPD and healthy subject（ P 〈0. 05 ） and PaCO2 was significantly higher in the lower BMI group（P 〈0. 05）. BMI in the lower BMI group was negatively correlated with total cell count and neutrophils in induced sputum and the levels of sedum CRP, IL-8, IL-6 and TNF-α respectively （ P 〈 0. 05 ）. Conclusion Airway and systemic inflammatory in stable COPD patients is closely related to BMI.