AECOPD患者hs-CRP水平与营养状况的关系研究

目的探讨慢性阻塞性肺疾病急性加重期（AECOPD）超敏c反应蛋白（hs-CRP）水平与营养状况的关系，为临床进行病情及营养状况预测及评估提供依据。方法选择177例AECOPD患者，进行hs-CRP水平与体重指数（BMI）、血清前血清蛋白（PA）、清蛋白（Alb）、血红蛋白（Hb）、淋巴细胞计数（LY）、总胆固醇（TC）等营养指标的相关性分析，研究营养状况与hs-CRP水平升高的关系，并比较不同营养状况间hs-CRP水平。结果AECOPD患者hs-CRP水平与PA、Alb、Hb以及TC等营养指标具有负相关性（r=-0．242，P=0．000；r=-0．193，P=0．000；r=-0．166，P=0．001；r=-0．289，P=0．002）。低蛋白血症（Alb〈35g／L）、低前清蛋白血症（PA〈180mg／L）和低胆固醇血症（TC〈3．1mmo/L）AECOPD患者hs-CRP显著升高，其发生率均显著高于正常水平患者（X^2=10．389，P=0．001；X^2=4．069，P=0．044；X^2=12．656，P=0．000）。其hs-CRP显著升高的几率比（OR）分别为2．931、1．851、11．172倍，低蛋白血症、低前清蛋白血症以及低胆固醇血症与hs-CRP显著升高有较强的关联度。低蛋白血症、低前清蛋白水平、贫血以及低胆固醇血症组hs-CRP水平显著高于正常水平组（z=-3．086，P=0．002；0=-3．284，P=0．001；z=-2．557，P：0．011；z=-3．942，P=0．000）。结论AECOPD患者hs-CRP水平与营养状况具有密切关系，可作为评价营养状况以及预后的指标之一。

Correlation between level of high sensitivity C-reactive protein and nutritional status in patients with acute exacerbated chronic obstructive pulmonary disease

Objective To discuss the correlation between the level of high sensitivity C-reactive protein(hs-CRP)and malnutrition in patients with acute exacerbalted chronic obstructive pulmonary disease(AECOPD),and to provide basis for the clinical prognosis and evaluation of the disease and nutriture.Methods The analysis of nutritional indexes such as the level of hs-CRP,body mass index(BMI),serum prealbumin(PA),albumin(Alb),hemoglobin(Hb),lymphocyte count(LY),and total cholesterol(TC)was made in 177 patients with AECOP.The correlation between nutriture and the increase of hs-CRP level was analyzed,and the hs-CRP levels in different nutriture were compared.Results There was a negative correlation between hs-CRP level and indexes such as PA,Alb,Hb,and TC(r=-0.242,P=0.000;r=-0.193,P=0.000;r=-0.166,P=0.001;r=-0.289,P=0.002).The incidence of significant hs-CRP increased in AECOPD patients with complication of hypoproteinemia(Alb<35 g/L),hypoprealbuminemia(PA<180 mg/L),and hypocholesterolemia(TC<3.1 mmol/L)was significantly higher than that in patients with normal levels(χ2=10.389,P=0.001;χ2=4.069,P=0.044;χ2=12.656,P=0.000).The odds ratios(OR)of the significant hs-CRP increase were 2.931,1.851,and 11.172 times,respectively.Hypoproteinemia,hypoprealbuminemia,and hypocholesterolemia had a strong correlation with the significant increase of hs-CRP level.The hs-CRP levels in patients with hypoproteinemia,hypoprealbuminemia,anaemia,and hypocholesterolemia were significantly higher than those in patients with normal levels(z=-3.086,P=0.002;z=-3.284,P=0.001;z=-2.557,P=0.011;z=-3.942,P=0.000).Conclusion The hs-CRP level is closely related to the nutriture in patients with AECOPD,which can be considered as one of the indexes evaluating the nutriture and prognosis.