發(fā)布時(shí)間：2018-12-07 10:25

【摘要】：目的探討不同臨床類型慢性阻塞性肺疾病(簡(jiǎn)稱慢阻肺)患者營(yíng)養(yǎng)狀態(tài)、血清瘦素、腫瘤壞死因子α(TNF-α)、白細(xì)胞介素8(IL-8)及C反應(yīng)蛋白(CRP)水平的差異。方法選取2012年1月至2013年12月在核工業(yè)四一六醫(yī)院呼吸內(nèi)科住院或門診隨訪的典型肺氣腫型慢阻肺患者52例(急性期27例,穩(wěn)定期25例;A組)和典型支氣管炎型慢阻肺患者68例(急性期36例,穩(wěn)定期32例;B組)。同期40例健康體檢者為對(duì)照組。測(cè)量各組營(yíng)養(yǎng)狀態(tài)的各項(xiàng)指標(biāo)[體重指數(shù)(BMI)、理想體重百分比、三頭肌皮皺厚度、上臂中部臂圍、白蛋白、淋巴細(xì)胞計(jì)數(shù)],采用放射免疫法檢測(cè)血清瘦素、TNF-α、IL-8水平;采用全自動(dòng)生化分析儀測(cè)定CRP水平。結(jié)果 B組營(yíng)養(yǎng)狀態(tài)的各項(xiàng)指標(biāo)均明顯高于A組(P0.05)。瘦素水平在A組穩(wěn)定期及B組穩(wěn)定期較對(duì)照組明顯降低[(7.76±2.93)ng/L和(10.04±5.11)ng/L比(14.93±8.47)ng/L,P0.05],在A組急性期及B組急性期[(12.99±5.56)ng/L和(13.52±5.82)ng/L]分別較同組穩(wěn)定期顯著升高(P0.05),在A組穩(wěn)定期[(7.76±2.93)ng/L]較B組穩(wěn)定期[(10.04±5.11)ng/L]明顯降低(P0.05)。TNF-α水平在A組急性期顯著高于B組急性期及對(duì)照組[(234.65±95.74)μg/L和(195.03±88.00)μg/L比(182.07±42.35)μg/L,P0.05],在A組穩(wěn)定期高于B組穩(wěn)定期[(225.31±84.14)μg/L比(188.17±72.62)μg/L,P0.05]。IL-8水平在A組、B組急性期及穩(wěn)定期均顯著高于對(duì)照組(P0.05),A組、B組之間及急性期與穩(wěn)定期之間IL-8水平無(wú)明顯差異(P0.05)。A組和B組急性期CRP水平均顯著高于對(duì)照組[(46.87±35.89)mg/L和(70.11±65.50)mg/L比(5.05±4.49)mg/L,P0.01],B組急性期CRP水平高于A組急性期(P0.05)。結(jié)論營(yíng)養(yǎng)狀態(tài)、瘦素、TNF-α和CRP水平在典型的肺氣腫型及支氣管炎型慢阻肺患者中有顯著差異,而IL-8水平在兩組中差異不大,瘦素和TNF-α可能參與慢阻肺營(yíng)養(yǎng)不良的發(fā)生。
[Abstract]:Objective to investigate the nutritional status, serum leptin, tumor necrosis factor 偽 (TNF- 偽), interleukin-8 (IL-8) and C-reactive protein (CRP) levels in patients with different clinical types of chronic obstructive pulmonary disease (COPD). Methods from January 2012 to December 2013, 52 patients with typical emphysema slow obstructive pulmonary disease (27 in acute phase and 25 in stable stage) in Department of Respiratory Medicine, 416 Hospital of Nuclear Industry, were followed up. Group A and 68 patients with typical bronchitis chronic obstructive pulmonary disease (acute 36 cases, stable 32 cases; group B). In the same period, 40 healthy persons were taken as control group. The nutritional status of each group was measured [body mass index (BMI),) ideal weight percentage, triceps skin wrinkle thickness, midarm circumference of upper arm, albumin, lymphocyte count]. Serum leptin and TNF- 偽 were measured by radioimmunoassay. IL-8 level; The level of CRP was measured by automatic biochemical analyzer. Results the nutritional status of group B was significantly higher than that of group A (P 0.05). Leptin levels in group A and group B were significantly lower than those in control group [(7.76 鹵2.93) ng/L and (10.04 鹵5.11) ng/L vs (14.93 鹵8.47) ng/L,P0.05]. In the acute phase of group A and group B, [(12.99 鹵5.56) ng/L and (13.52 鹵5.82) ng/L] were significantly higher than those in the stable phase of the same group (P0.05). The level of TNF- 偽 in group A [(7.76 鹵2.93) ng/L] was significantly lower than that in group B [(10.04 鹵5.11) ng/L] (P0.05). The level of TNF- 偽 in group A was significantly higher than that in group B and control group (P0.05). [(234.65 鹵95.74) 渭 g / L vs (195.03 鹵88.00) 渭 g / L: (182.07 鹵42.35) 渭 g / L, The level of IL-8 in group A was significantly higher than that in group B [(225.31 鹵84.14) 渭 g / L vs (188.17 鹵72.62) 渭 g / L]. The acute and stable phase in group B was significantly higher than that in control group (P0.05). There was no significant difference in IL-8 level between group B and group B (P0.05) CRP levels in). A group and group B were significantly higher than those in control group [(46.87 鹵35.89) mg/L and (70.11 鹵65.50) mg/]. L ratio (5.05 鹵4.49) mg/L, The level of CRP in group B was higher than that in group A (P 0.05). Conclusion there are significant differences in nutritional status, leptin, TNF- 偽 and CRP levels in patients with typical emphysema and bronchitis chronic obstructive pulmonary disease, but there is no significant difference in IL-8 level between the two groups. Leptin and TNF- 偽 may be involved in the development of chronic obstructive pulmonary malnutrition.
【作者單位】： 核工業(yè)四一六醫(yī)院呼吸內(nèi)科;
【基金】：四川省衛(wèi)生廳科研課題(編號(hào):089142)
【分類號(hào)】：R563.9

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