【摘要】 目的 基于代谢组学氨基酸代谢水平，探究慢性阻塞性肺疾病（COPD）患者血浆犬尿氨酸（Kyn）/色氨酸（Trp）的比值（KTR）与COPD评估量表（CAT）评分的相关性。方法 选取2021年6月至2022年9月阜阳市人民医院收治的COPD患者85例为COPD组，另选取60例健康体检者作为对照组。根据CAT评分将COPD组分为轻度组、中度组、重度组和极重度组。比较COPD组和对照组及不同CAT评分组间血浆Trp、Kyn水平，KTR和肺功能指标[第1秒用力呼气容积（FEV₁）、用力肺活量（FVC）、FEV₁/FVC比值];采用Pearson相关分析血浆Trp、Kyn、KTR水平与肺功能指标及CAT评分的相关性；比较COPD患者治疗前后CAT评分及KTR。结果 COPD组FEV₁、FVC、Trp水平及FEV₁/FVC比值低于对照组，KTR高于对照组，差异均有统计学意义（P<0.05）。极重度和重度组FEV₁、FVC、Trp水平及FEV₁/FVC比值低于轻度组和中度组，差异均有统计学意义（P<0.05）。极重度组的Kyn水平和KTR高于轻度组、中度组和重度组，差异均有统计学意义（P<0.05）。FEV₁、FVC、FEV₁/FVC与Trp呈正相关，与Kyn、KTR呈负相关（P<0.05）;CAT评分与Trp呈负相关，与Kyn、KTR呈正相关（P<0.05）。COPD患者出院时KTR及CAT各项评分比入院时明显下降，差异均有统计学意义（P<0.05）。结论 Trp、Kyn、KTR是监测COPD患者疾病进展新的生物标志物，联合CAT评分可以更全面地反映COPD的严重程度。更多还原

【Abstract】 Objective To explore the correlation between plasma kynurenine（Kyn）/tryptophan（Trp） ratio（KTR） and COPD assessment scale（CAT） score in patients with chronic obstructive pulmonary disease（COPD） based on the amino acid metabolism level of metabolomics.Methods A total of 85 COPD patients admitted to Fuyang People′s Hospital from June 2021 to September 2022 were selected as the COPD group, and 60 healthy subjects were selected as the control group.According to the CAT score, the COPD group was divided into mild group, moderate group, severe group and very severe group.The plasma levels of Trp, Kyn, KTR and pulmonary function indexes[forced expiratory volume in one second（FEV₁）,forced vital capacity（FVC）,FEV₁/FVC ratio]were compared between COPD group and control group, and different CAT score groups.Pearson correlation analysis was used to analyze the correlation of plasma Trp, Kyn, KTR levels with pulmonary function indexes and CAT score.The CAT scores and KTR of COPD patients before and after treatment were compared.Results The levels of FEV₁,FVC,Trp and FEV₁/FVC ratio in the COPD group were lower than those in the control group, and the KTR was higher than that in the control group, and the differences were statistically significant（P<0.05）.The levels of FEV₁,FVC,FEV₁/FVC ratio and Trp in the extremely severe and severe groups were lower than those in the mild and moderate groups, and the differences were statistically significant（P<0.05）.The levels of Kyn and KTR in the extremely severe group were higher than those in the mild, moderate and severe groups, and the differences were statistically significant（P<0.05）.FEV₁,FVC,FEV₁/FVC ratio were positively correlated with Trp, and negatively correlated with Kyn and KTR（P<0.05）.CAT score was negatively correlated with Trp, and positively correlated with Kyn and KTR（P<0.05）.The CAT scores and KTR of COPD patients at discharge were significantly lower than those at admission, and the differences were statistically significant（P<0.05）.Conclusion Trp, Kyn and KTR are new biomarkers for monitoring the progression of COPD.Combined with CAT score, they can reflect the severity of COPD more comprehensively.更多还原