| 摘要: |
| 目的 研究慢性阻塞性肺疾病急性加重期(AECOPD)患者的血脂水平与炎症因子的相关性。方法 选择2018-03～/2019-03住院治疗的AECOPD患者152例，根据有无呼吸衰竭分为呼吸衰竭组62例和非呼吸衰竭组90例。呼吸衰竭组均为II型呼吸衰竭。检测两组患者的相关指标并对比分析，包括总胆固醇（TC）、甘油三酯（TG）、高密度脂蛋白（HDL-C）、低密度脂蛋白（LDL-C）、降钙素原(PCT) 、白介素-6(IL-6)、C反应蛋白( CRP)、动脉血氧分压（PaO2）、动脉血二氧化碳分压（PaCO2）、第1秒用力呼气容积占预计值百分比( FEV1% )和第1秒用力呼气容积/用力肺活量( FEV1 /FVC)。采用Pearson相关性分析患者炎症因子、血脂水平与血气、肺功能指标相关性以及血脂水平与炎症因子的相关性。结果 呼吸衰竭组血清炎症因子PCT、IL-6、CRP、血气指标PaCO2水平均显著高于非呼吸衰竭组，差异有统计学意义(P＜0.01) ；呼吸衰竭组血脂水平TC、TG、HDL-C、血气指标PaO2、肺功能指标FEV1%、FEV1/FVC均显著低于非呼吸衰竭组，差异有统计学意义(P＜0.01 ),LDL-C变化无统计学意义（P＞0.05）。Pearson相关性分析结果显示：AECOPD患者PCT、IL-6、CRP与PaO2、FEV1%、FEV1/FVC呈显著负相关性（P＜0.001），与PaCO2呈显著正相关性（P＜0.001）；血脂TC、TG、HDL-C与PaO2、FEV1%、FEV1/FVC呈正相关性（P＜0.05），与PaCO2呈负相关性（P＜0.05）。LDL-C与PaO2、PaCO2、FEV1%、FEV1/FVC相关性很低（P＞0.05）；TC、TG、HDL-C 与PCT、IL-6、CＲP均呈负相关（P＜0.01），LDL-C与PCT、IL-6、CＲP相关性很低（P＞0.05）。结论 AECOPD患者炎症因子明显升高，血脂TC、TG、HDL-C水平明显降低，血脂水平与炎性因子呈负性相关，提示两者水平变化可反映患者病情严重程度。 |
| 关键词: AECOPD 血脂 PCT IL-6 CRP |
| DOI： |
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| Correlation between blood lipid levels and PCT, IL-6 and CRP levels in patients with acute exacerbation of chronic obstructive pulmonary disease |
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李方方, Zhang Tieshuan
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the Second Affiliated Hospital of Zhengzhou University
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| Abstract: |
| Objective To study the correlation between serum lipid levels and inflammatory factors in patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD). Methods A total of 152 patients with AECOPD who were hospitalized from 2018-03 to 2019-03 were enrolled. According to the presence or absence of respiratory failure, they were divided into 62 patients with respiratory failure and 90 patients with non-respiratory failure. The respiratory failure group was type II respiratory failure. The relevant indicators of the two groups of patients were tested and compared, including total cholesterol (TC), triglyceride (TG), high-density lipoprotein (HDL-C), low-density lipoprotein (LDL-C), procalcitonin ( PCT), interleukin-6 (IL-6), C-reactive protein (CRP), arterial partial pressure of oxygen (PaO2), arterial partial pressure of carbon dioxide (PaCO2), forced expiratory volume in 1 second as a percentage of predicted value (FEV1) %) and forced expiratory volume/forced vital capacity (FEV1 / FVC) in the first second. Pearson correlation was used to analyze the correlation between inflammatory factors, blood lipid levels and blood gas, lung function indicators, and blood lipid levels and inflammatory factors. Results The levels of serum inflammatory factors PCT, IL-6, CRP, and blood gas index PaCO2 in the respiratory failure group were significantly higher than those in the non-respiratory failure group (P<0.01). The blood lipid levels in the respiratory failure group were TC, TG, HDL-C. The blood gas index PaO2, lung function index FEV1%, FEV1/FVC were significantly lower than the non-respiratory failure group, the difference was statistically significant (P<0.01), LDL-C change was not statistically significant (P>0.05). Pearson correlation analysis showed that PCT, IL-6 and CRP were significantly negatively correlated with PaO2, FEV1% and FEV1/FVC in AECOPD patients (P<0.001), and positively correlated with PaCO2 (P<0.001); TC, TG and HDL-C were positively correlated with PaO2, FEV1% and FEV1/FVC (P<0.05), and negatively correlated with PaCO2 (P<0.05). The correlation between LDL-C and PaO2, PaCO2, FEV1% and FEV1/FVC was very low (P>0.05). TC, TG and HDL-C were negatively correlated with PCT, IL-6 and CRP (P<0.01). LDL The correlation between -C and PCT, IL-6 and CRP was very low (P>0.05). Conclusion The inflammatory factors of AECOPD patients were significantly increased, the levels of blood lipids TC, TG and HDL-C were significantly decreased, and the levels of blood lipids were negatively correlated with inflammatory factors, suggesting that the changes of the two levels may reflect the severity of the patients. |
| Key words: AECOPD blood lipid procalcitonin, interleukin-6 C-reactive protein |
