慢性阻塞性肺疾病患者血浆网膜素-1 水平与病情严重程度的相关性研究_Chinese Journal of Respiratory and Critical Care Medicine

Authors：

唐楠 ¹ , 陶韬 ¹ , 周学刚 ¹ , 廖秀清 ¹ , 朱涛 ² ,  王导新 ²

1. ;
2. ;

Corresponding author：

王导新, Email: wangdaoxin1@163.com

Keywords：

慢性阻塞性肺疾病; 网膜素-1; 临床评价; 相关性

DOI：

10.7507/1671-6205.201905069

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目的研究血浆网膜素-1 在慢性阻塞性肺疾病（简称慢阻肺）患者临床评价中的价值，并进一步探讨其与慢阻肺急性加重病情严重程度的相关性。方法选取 124 例慢阻肺患者，按照病程分为急性加重组（64 例）与稳定期组（60 例），另选取 60 例无慢阻肺的健康成人作为对照组。急性加重组按照病情严重程度进行临床分级。检测研究对象的血浆网膜素-1 水平；分析慢阻肺患者血浆网膜素-1 水平与第 1 秒用力呼气容积占预计值百分比（FEV₁%pred）、用力肺活量占预计值百分比（FVC%pred）、GOLD 分级、改良呼吸困难指数（mMRC）评分、急性加重风险评估分组、氧合指数（PaO₂/FiO₂）、动脉血二氧化碳分压（PaCO₂）、慢阻肺急性加重临床分级等指标的相关性。结果慢阻肺患者的血浆网膜素-1 水平明显低于对照组（P<0.05），其中慢阻肺急性加重组的血浆网膜素-1 水平较稳定期组更低（P<0.01）。慢阻肺患者的血浆网膜素-1 水平与 FEV₁%pred、FVC%pred 呈正相关，与 GOLD 分级、mMRC 评分、CAT 评分呈负相关（P<0.01）。慢阻肺急性加重患者血浆网膜素-1 水平与 PaO₂/FiO₂ 呈正相关，与 PaCO₂、呼吸衰竭类型、中性粒细胞百分比、住院天数、机械通气时间呈显著负相关（P<0.05）。随着 GOLD 分级的增加，慢阻肺急性加重患者血浆网膜素-1 水平进行性降低，在 ABCD 综合评估中临床症状越重者其血浆网膜素-1 水平越低。慢阻肺急性加重患者的血浆网膜素-1 水平与临床分级与呈显著负相关（P<0.01）。血浆网膜素-1 水平在慢阻肺急性加重不同临床分级之间有显著差异（P<0.05）。与入院第 1 天相比，慢阻肺急性加重患者出院前 1 天的血浆网膜素-1 水平明显增高（P<0.01）。结论血浆网膜素-1 与慢阻肺临床评价指标具有一定相关性，可作为评估急性加重的生物学标志物。

Citation： 唐楠, 陶韬, 周学刚, 廖秀清, 朱涛, 王导新. 慢性阻塞性肺疾病患者血浆网膜素-1 水平与病情严重程度的相关性研究. Chinese Journal of Respiratory and Critical Care Medicine, 2020, 19(4): 398-402. doi: 10.7507/1671-6205.201905069 Copy

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2.	Ohashi K, Shibata R, Murohara T, et al. Role of anti-inflammatory adipokines in obesity-related diseases. Trends Endocrinol Metab, 2014, 25(7): 348-355.
3.	Kazama K, Usui T, Okada M, et al. Omentin plays an anti-inflammatory role through inhibition of TNF-α-induced superoxide production in vascular smooth muscle cells. Eur J Pharmacol, 2012, 686(1-3): 116-123.
4.	慢性阻塞性肺疾病急性加重(AECOPD) 诊治专家组. 慢性阻塞性肺疾病急性加重 (AECOPD) 诊治中国专家共识 (2017 年更新版). 国际呼吸杂志, 2017, 37(14): 1041-1057.
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6.	Polosukhin VV, Richmond BW, Du RH, et al. Secretory IgA Deficiency in individual small airways is associated with persistent inflammation and remodeling. Am J Respir Crit Care Med, 2017, 195(8): 1010-1021.
7.	Zhang DM, Pang XL, Huang R, et al. Adiponectin, omentin, ghrelin, and visfatin levels in obese patients with severe obstructive sleep apnea. Biomed Res Int, 2018, 2018: 3410135.
8.	Zhou Y, Zhang B, Hao C, et al. Omentin--a novel adipokine in respiratory diseases. Int J Mol Sci, 2017, 19(1): E73.
9.	Kataoka Y, Shibata R, Ohashi K, et al. Omentin prevents myocardial ischemic injury through AMP-activated protein kinase-and Akt-dependent mechanisms. J Am Coll Cardiol, 2014, 63(24): 2722-2733.
10.	Mancuso P. Obesity and lung inflammation. J Appl Physiol, 2010, 108(3): 722-728.
11.	Yan P, Liu D, Long M, et al. Changes of serum omentin levels and relationship between omentin and adiponectin concentrations in type 2 diabetes mellitus. Exp Clin Endocrinol Diabetes, 2011, 119(4): 257-263.
12.	Wang C. Obesity, inflammation, and lung injury (OILI): the good. Mediators Inflamm, 2014, 2014: 978463.

1. Wang C, Xu J, Yang L, et al. Prevalence and risk factors of chronic obstructive pulmonary disease in China (the China Pulmonary Health [CPH] study): a national cross-sectional study. Lancet, 2018, 391(10131): 1706-1717.
2. Ohashi K, Shibata R, Murohara T, et al. Role of anti-inflammatory adipokines in obesity-related diseases. Trends Endocrinol Metab, 2014, 25(7): 348-355.
3. Kazama K, Usui T, Okada M, et al. Omentin plays an anti-inflammatory role through inhibition of TNF-α-induced superoxide production in vascular smooth muscle cells. Eur J Pharmacol, 2012, 686(1-3): 116-123.
4. 慢性阻塞性肺疾病急性加重(AECOPD) 诊治专家组. 慢性阻塞性肺疾病急性加重 (AECOPD) 诊治中国专家共识 (2017 年更新版). 国际呼吸杂志, 2017, 37(14): 1041-1057.
5. Richmond BW, Du RH, Han W, et al. Bacterial-derived neutrophilic inflammation drives lung remodeling in a mouse model of COPD. Am J Respir Cell Mol Biol, 2018, 58(6): 736-744.
6. Polosukhin VV, Richmond BW, Du RH, et al. Secretory IgA Deficiency in individual small airways is associated with persistent inflammation and remodeling. Am J Respir Crit Care Med, 2017, 195(8): 1010-1021.
7. Zhang DM, Pang XL, Huang R, et al. Adiponectin, omentin, ghrelin, and visfatin levels in obese patients with severe obstructive sleep apnea. Biomed Res Int, 2018, 2018: 3410135.
8. Zhou Y, Zhang B, Hao C, et al. Omentin--a novel adipokine in respiratory diseases. Int J Mol Sci, 2017, 19(1): E73.
9. Kataoka Y, Shibata R, Ohashi K, et al. Omentin prevents myocardial ischemic injury through AMP-activated protein kinase-and Akt-dependent mechanisms. J Am Coll Cardiol, 2014, 63(24): 2722-2733.
10. Mancuso P. Obesity and lung inflammation. J Appl Physiol, 2010, 108(3): 722-728.
11. Yan P, Liu D, Long M, et al. Changes of serum omentin levels and relationship between omentin and adiponectin concentrations in type 2 diabetes mellitus. Exp Clin Endocrinol Diabetes, 2011, 119(4): 257-263.
12. Wang C. Obesity, inflammation, and lung injury (OILI): the good. Mediators Inflamm, 2014, 2014: 978463.

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慢性阻塞性肺疾病患者血浆网膜素-1 水平与病情严重程度的相关性研究

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