慢性阻塞性肺疾病急性加重期患者炎性因子水平及糖代谢状态

目的探讨慢性阻塞性肺疾病急性加重期(AECOPD)患者炎性因子水平改变及糖代谢状态。方法选择AECOPD患者80例(AECOPD组)、慢性阻塞性肺疾病(COPD)稳定期患者78例(COPD稳定期组)和健康对照者75例(对照组),测定其空腹血糖(FBG)、餐后2 h血糖(2hPBG)、体质量指数(BMI)、胰岛素抵抗指数(HOMA-IR)、血清瘦素(LEP)、超敏C反应蛋白(hs-CRP)、肿瘤坏死因子-α(TNF-α)和白细胞介素-6(IL-6)水平。结果 COPD稳定期组和AECOPD组患者hs-CRP、TNF-α、IL-6和LEP水平显著高于对照组(P<0.01),AECOPD组患者hs-CRP、TNF-α、IL-6和LEP水平显著高于COPD稳定期组(P<0.05)。COPD稳定期组和AECOPD组患者FBG、2hPBG和HOMA-IR均显著高于对照组(P<0.01),AECOPD组患者FBG、2hPBG和HOMA-IR均显著高于COPD稳定期组(P<0.05);3组BMI比较差异无统计学意义(P>0.05)。各组LEP与2hPBG、HOMA-IR和BMI均呈正相关(P<0.05),AECOPD组LEP与hs-CRP呈正相关(P<0.05),对照组和COPD稳定期组LEP与hs-CRP无显著相关性(P>0.05)。结论AECOPD患者血清炎性因子水平升高,并存在胰岛素抵抗;LEP与hs-CRP、HOMA-IR及BMI有一定的相关性。

Inflammation factor levels and glycometabolic state in patients with acute exacerbation of chronic obstructive pulmonary disease

Objective To explore the changes of inflammation factor levels and glycometabolic state in patients with acute exacerbation of chronic obstructive pulmonary disease(AECOPD).Methods Eighty patients with AECOPD(AECOPD group),seventy-eight patients with COPD at stable phase(COPD stable phase group) and seventy-five healthy people(control group)were selected.The levels of fasting blood glucose(FBG),2-hour postprandial blood glucose(2hPBG),body mass index(BMI),insulin resistance index(HOMA-IR),leptin(LEP),hypersensitive C-reactive protein(hs-CRP),tumor necrosis factor-α(TNF-α)and interleukin-6(IL-6)were detected.Results The levels of hs-CRP,TNF-α,IL-6 and LEP in COPD stable phase group and AECOPD group were significantly higher than those in control group(P<0.01);the levels of hs-CRP,TNF-α,IL-6 and LEP in AECOPD group were significantly higher than those in COPD stable phase group(P<0.05).The levels of FBG,2hPBG and HOMA-IR in COPD stable phase group and AECOPD group were significantly higher than those in control group(P<0.01);the levels of FBG,2hPBG and HOMA-IR in AECOPD group were significantly higher than those in COPD stable phase group(P<0.05).There was no significant difference in BMI among the three groups(P>0.05).The LEP level was positively correlated to 2hPBG,HOMA-IR and BMI in the three groups(P<0.05);the LEP level was positively correlated to hs-CRP level in AECOPD group(P<0.05);the LEP level wasn′t related to hs-CRP level in control group and COPD stable phase group(P>0.05).Conclusions The levels of serum inflammatory factors are high,and the insulin resistance exists in patients with AECOPD;LEP is related to hs-CRP,HOMA-IR and BMI in patients with AECOPD.