C 反应蛋白与老年慢性阻塞性肺疾病患者胰岛素抵抗的相关性分析

目的：研究老年慢性阻塞性肺疾病(COPD)患者体内 C 反应蛋白(CRP)水平变化及其与胰岛素抵抗的相关性。方法上海交通大学医学院附属新华医院崇明分院收治86例老年 COPD 患者,按疾病状态分为 COPD 急性加重期(AECOPD)组和 COPD 稳定期组,同时选取同期该院健康体检人员48例作为对照组。采集患者基本资料,同时留取静脉血,检测各组患者 CRP、空腹血糖(FPG)、餐后2h 血糖(2 hPBG)、空腹胰岛素(FINS)、总胆固醇(TC)、甘油三酯(TG)等生化指标,计算胰岛素抵抗指数(HOMA-IR)来评价患者胰岛素抵抗水平,统计并分析 CRP 与患者胰岛素抵抗相关性。结果 AECOPD 组 CRP、2 hPBG及 FINS 明显高于 COPD 稳定组和对照组,差异均具有统计学意义(P <0.05)；FPG 显著高于对照组(P <0.05)。AECOPD 组 HOMA-IR 为3.98±1.21,明显高于 COPD 稳定组的2.41±1.65和对照组为1.68±0.46,差异也具有统计学意义(P <0.05)。COPD 稳定组 CRP、FINS、HOMA-IR 与对照组相比显著升高(P <0.05)。AECOPD 患者 CRP 与2 hPBG、FINS、HOMA-IR 成正相关(r 分别为0.642、0.698、0.602,P <0.05),而 COPD 稳定期患者 CRP 与 FPG、2 hPBG、FINS、HOMA-IR 均无相关性。结论老年COPD 患者血浆 CRP 水平升高并伴有一定的胰岛素抵抗。AECOPD 组 CRP 水平与胰岛素抵抗存在一定的相关性。

Correlation between C-reactive protein and insulin resistance in senile patients with chronic obstructive pulmonary disease

Objective To investigate C-reactive protein（CRP） level in senile patients with acute exacerbation of chronic obstructive pulmonary disease（AECOPD） and patients with stable COPD and evaluate its relationship with insulin resistance. Methods Eighty-six patients with COPD were recruited from Chongming Branch of Xinhua Hospital and divide into AECOPD group and stable COPD group according to the course of disease and 48 healthy volunteers were enrolled as controls at the same time. Baseline materials of patients were collected and CRP, fasting blood glucose （FPG）, 2 hour postprandial blood glucose （2 hPBG）, fasting insulin（FINS）, blood lipids were detected. Insulin Resistance Index（HOMA-IR） was calculated and used to assess the level of insulin resistance. The relationship between CRP and parameters above were analyzed. Results The levels of CRP, 2 hPBG,and FINS were significantly higher in AECOPD group than those in stable COPD group and control group,and FPG was also higher than control group（ P 〈 0.05）. The HOMA-IR of AECOPD group was 3.98 ±1.21, which was much higher than that of stable COPD group and control group 2.41± 1.65 and 1.68±0.46, respectively（ P 〈0.05）. Meanwhile, there were significant increase in the levels of CRP, FINS, HOMA-IR in stable COPD group compared with those of control group （P 〈0.05）. According to the correlation analysis, there were positive correlation of CRP,2 hPBG, FINS, HOMA-IR in AECOPD group（ r = 0. 642,0. 698,0. 602, all P 〈 0.05） . However, no correlation were detected of CRP and FPG, 2 hPBG, FINS,HOMA-IR in stable COPD group. Conclusion CRP and insulin resistance increased in senile COPD patients. CRP level was related to insulin resistance only in AECOPD patients.