探討維生素D與COPD急性加重頻率、合并癥及免疫反應(yīng)的相關(guān)關(guān)系
發(fā)布時間：2018-11-11 14:35
【摘要】：目的:通過檢測COPD患者血清VitD水平,以初步了解COPD患者VitD缺乏的情況及其對疾病嚴(yán)重程度的影響,并探討VitD影響COPD患者病情的免疫學(xué)機制。方法:收集2016年3月-2016年11月在寧夏醫(yī)科大學(xué)總醫(yī)院呼吸科就診的穩(wěn)定期COPD患者60例,及與之年齡、性別、就診時間匹配的健康體檢者26例,通過電化學(xué)發(fā)光法檢測所有受試者血清VitD濃度水平。收集COPD患者BMI、既往1年加重次數(shù)、CAT評分、是否存在心血管疾病的合并癥、血鈣和血磷等臨床資料,并檢測肺功能,比較Vit D缺乏組COPD患者與VitD不缺乏組的患者上述指標(biāo)的差異,來了解VitD對COPD患者病情嚴(yán)重程度的影響。同時檢測COPD患者組的抗核抗體(ANAs)、IL-10及TGF-β1的水平,分析VitD與上述指標(biāo)的相關(guān)性。結(jié)果:COPD組患者的VitD水平明顯低于對照組[(14.534?7.313)vs(24.42?10.909)ng/ml];(P0.05)];COPD患者VitD缺乏的患病率(73.01%)明顯高于對照組的,差異有統(tǒng)計學(xué)意義(P0.05);缺乏VitD的COPD患者的血Ca低于不缺乏VitD的COPD患者[(2.16?0.116)vs(2.25?0.115)nom/l;(P0.05)];缺乏VitD的COPD患者FEV1/預(yù)計值(%)低于不缺乏VitD的COPD患者[(47.33?16.31)vs(58.43?17.784)%;(P0.05)];VitD缺乏的COPD患者CAT評分分值高于VitD不缺乏組的[(20.57?2.986)vs(18.64?3.342);(P0.05)]。VitD缺乏的COPD患者IL-10水平低于VitD不缺乏組[(24.73?2.834)vs(28.187?4.541)pg/ml;(P0.05)];VitD缺乏組的COPD患者的TGF-β1水平低于VitD不缺乏的患者[(1.29?0.499)vs(1.73?0.687)pg/ml;(P0.05)],COPD患者VitD與ANAs陽性患病率無相關(guān)關(guān)系。結(jié)論:COPD患者的血清VitD水平較對照組低,同時其VitD缺乏的患病率較健康對照組明顯增高。VitD缺乏的COPD患者其生活質(zhì)量及肺功能更差,同時其既往加重次數(shù)更多,病情更嚴(yán)重。VitD未通過產(chǎn)生抗核抗體(ANAs)的機制來影響COPD的病情進(jìn)展;VitD缺乏的COPD患者其IL-10、TGF-β1水平顯著低于VitD不缺乏組,VitD可能通過促進(jìn)IL-10、TGF-β1的分泌而發(fā)揮免疫調(diào)節(jié)功能。
[Abstract]:Objective: to investigate the level of serum VitD in patients with COPD and its influence on the severity of VitD in COPD patients, and to explore the immunological mechanism of VitD affecting the patients with COPD. Methods: from March 2016 to November 2016, 60 patients with stable COPD, 26 matched with age, sex and time, were collected from Department of Respiratory, General Hospital of Ningxia Medical University. The concentration of serum VitD in all subjects was measured by electrochemiluminescence (ECL). The clinical data of BMI, exacerbation in one year, CAT score, complication of cardiovascular disease, serum calcium and phosphorus were collected in patients with COPD, and pulmonary function was measured. In order to understand the influence of VitD on the severity of COPD, we compared the above indexes between COPD patients with Vit D deficiency and those with no VitD deficiency. At the same time, the levels of (ANAs), IL-10 and TGF- 尾 1 were detected in patients with COPD, and the correlation between VitD and the above indexes was analyzed. Results: the level of VitD in COPD group was significantly lower than that in control group [(14.534 鹵7.313) vs (24.42) vs (10.909 ng/ml]; (P0.05); The prevalence of VitD deficiency in COPD patients (73.01%) was significantly higher than that in the control group (P0.05). The serum Ca in COPD patients with VitD deficiency was lower than that in COPD patients without VitD [(2.160.116) vs (2.250.115) nom/l; (P0.05)]; The FEV1/ predictive value (%) of COPD patients without VitD was lower than that of COPD patients without VitD deficiency [(47.33 ~ 16.31) vs (58.43 ~ 17.784)%; (P0.05)]; The CAT score of COPD patients with VitD deficiency was higher than that of COPD patients without VitD deficiency [(20.570.986) vs (18.643.342)]. (P 0.05). The level of IL-10 in COPD patients with VitD deficiency was lower than that in patients without VitD deficiency [(24.732.834) vs (28.1874.541) pg/ml; (P0.05)]; The levels of TGF- 尾 1 in COPD patients with VitD deficiency were lower than those without VitD deficiency [(1.290.99) vs (1.730.687) pg/ml; (P0.05)]. There was no correlation between VitD and ANAs positive prevalence in COPD patients. Conclusion: the serum VitD level of COPD patients is lower than that of the control group, and the prevalence of VitD deficiency is significantly higher than that of the healthy control group. The quality of life and lung function of COPD patients with VitD deficiency are worse, and the number of previous exacerbations is more frequent. VitD did not influence the progression of COPD through the mechanism of producing (ANAs); The level of IL-10,TGF- 尾 1 in COPD patients with VitD deficiency was significantly lower than that in patients without VitD deficiency. VitD may play an immunomodulatory role by promoting the secretion of IL-10,TGF- 尾 1.
【學(xué)位授予單位】：寧夏醫(yī)科大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R563.9
本文編號：2325137
[Abstract]:Objective: to investigate the level of serum VitD in patients with COPD and its influence on the severity of VitD in COPD patients, and to explore the immunological mechanism of VitD affecting the patients with COPD. Methods: from March 2016 to November 2016, 60 patients with stable COPD, 26 matched with age, sex and time, were collected from Department of Respiratory, General Hospital of Ningxia Medical University. The concentration of serum VitD in all subjects was measured by electrochemiluminescence (ECL). The clinical data of BMI, exacerbation in one year, CAT score, complication of cardiovascular disease, serum calcium and phosphorus were collected in patients with COPD, and pulmonary function was measured. In order to understand the influence of VitD on the severity of COPD, we compared the above indexes between COPD patients with Vit D deficiency and those with no VitD deficiency. At the same time, the levels of (ANAs), IL-10 and TGF- 尾 1 were detected in patients with COPD, and the correlation between VitD and the above indexes was analyzed. Results: the level of VitD in COPD group was significantly lower than that in control group [(14.534 鹵7.313) vs (24.42) vs (10.909 ng/ml]; (P0.05); The prevalence of VitD deficiency in COPD patients (73.01%) was significantly higher than that in the control group (P0.05). The serum Ca in COPD patients with VitD deficiency was lower than that in COPD patients without VitD [(2.160.116) vs (2.250.115) nom/l; (P0.05)]; The FEV1/ predictive value (%) of COPD patients without VitD was lower than that of COPD patients without VitD deficiency [(47.33 ~ 16.31) vs (58.43 ~ 17.784)%; (P0.05)]; The CAT score of COPD patients with VitD deficiency was higher than that of COPD patients without VitD deficiency [(20.570.986) vs (18.643.342)]. (P 0.05). The level of IL-10 in COPD patients with VitD deficiency was lower than that in patients without VitD deficiency [(24.732.834) vs (28.1874.541) pg/ml; (P0.05)]; The levels of TGF- 尾 1 in COPD patients with VitD deficiency were lower than those without VitD deficiency [(1.290.99) vs (1.730.687) pg/ml; (P0.05)]. There was no correlation between VitD and ANAs positive prevalence in COPD patients. Conclusion: the serum VitD level of COPD patients is lower than that of the control group, and the prevalence of VitD deficiency is significantly higher than that of the healthy control group. The quality of life and lung function of COPD patients with VitD deficiency are worse, and the number of previous exacerbations is more frequent. VitD did not influence the progression of COPD through the mechanism of producing (ANAs); The level of IL-10,TGF- 尾 1 in COPD patients with VitD deficiency was significantly lower than that in patients without VitD deficiency. VitD may play an immunomodulatory role by promoting the secretion of IL-10,TGF- 尾 1.
【學(xué)位授予單位】：寧夏醫(yī)科大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R563.9
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