慢性阻塞性肺疾病患者血清瘦素水平与炎性反应相关性

目的 探讨慢性阻塞性肺疾病(COPD)患者血清瘦素水平变化及其与炎性反应的关系,了解瘦素在COPD患者炎症反应过程中的作用及其意义.方法 选择COPD患者共58例,COPD急性加重期(Ⅰ组)30例,COPD缓解期(Ⅱ组)28例,正常对照组28例.测定和计算各组的多项营养指标,包括身高、体重、体重指数(BMI)、理想体重百分比(NM%)、体脂百分比(fat%).用酶联免疫吸附试验法(ELISA)测定58例COPD患者和28例正常人的血清瘦素、肿瘤坏死因子-α(TNF-α)、白细胞介素-8(IL-8)、超敏C-反应蛋白(hs-CRP)水平及肺功能,分析瘦素与各项参数的相关性.结果 ①COPD患者的各营养指标:BMI、NM%、fat%均显著低于正常对照组(P<0.01).②COPD I组血清瘦素、TNF-α、IL-8、hs-CRP均显著高于正常组与COPDⅡ组(P<0.01);COPDⅡ组血清瘦素低于正常组(P<0.01),TNF-α、IL-8、hs -CRP高于对照组(P<0.01);③COPD患者的瘦素含量与BMI、NM%、fat%、TNF-α、IL-8、hs -CRP水平显著正相关.结论 血清瘦素在COPD急性加重期明显高于缓解期,并与营养参数、TNF-α、IL-8、hs -CRP呈显著正相关,提示瘦素可能与COPD的疾病本身和全身炎症反应有关,可作为COPD急性加重期的炎症标志物.Abstract：Objective To investigate the expression and significance of serum leptin in patients with chronic obstructive pulmonary disease(COPD). Methods Thirty COPD patients in acute exacerbations phase (group I), 28 COPD patients in stationary phase(group Ⅱ) and 28 healthy controls were studied. Body height, body mass，body mass index (BMI), percentage of normal body mass (NM%), percentage of body fat(fat%) were determined.The serum leptin、TNF-α、IL-8、hs-CRP levels were examined by ELISA. The correlation between leptin and other parameters was analysed. Results ①BMI，NM% fat% in COPD patients significantly lower than those in healthy controls (P<0.01). ②Serum leptin、TNF-α、IL-8、hs-CRP level was significantly higher in group I than that in healthy controls and in group II (P<0.01); Serum leptin level was significantly lower in group II than that in healthy controls (P<0.01); Serum TNF-α、IL-8、hs-CRP level was higher in healthy controls (P<0.01). ③The leptin level was associated positively with BMI，NM%, fat%. TNF-α、IL-8、hs-CRP level of COPD. Conclusions The leptin level of COPD in acute is higher than that in stationary, and the levels were correlated to nutritional parameters,TNF-α,IL-8,hs-CRP.The result suggests that leptin may play a role in systemic inflamination of COPD, the leptin is an inflaming mark of the actue exacerbation phase in patients with COPD.

Serum leptin and the relationship between serum leptin and inflammatory responses in patients with chronic obstructive pulmonary disease

Chronic obstructive pulmomary disease Leptin Tumor necrosis factor-α lnterleukin-8 High-sensitivity C reactive protein