【作者】 李艳；

【导师】 罗红；

【作者基本信息】 中南大学 ， 呼吸内科， 2009， 硕士

【摘要】 目的:通过检测COPD患者急性期和稳定期血清瘦素和白细胞介素6的水平,初步探讨其与营养状况和生活质量的关系。方法:健康对照组15例,为我院同期健康体检者;COPD患者65人:其中COPD稳定期非营养不良组15例,COPD稳定期营养不良组15例,为我科同期门诊定期随访的稳定期患者;COPD急性加重期患者35例,为我科2008年10月-2009年3月因急性发作的住院患者。测定和计算各营养指标,包括身高、体重、身体质量指数(BMI)、血清白蛋白(ALB)、总淋巴细胞计数(LYM)、理想体重百分比(IBW%)、理想体重。用酶联免疫吸附实验法(ELISA)测定15例健康人和65例COPD患者的血清瘦素(Leptin)和白细胞介素6(IL-6)。用SGRQ表对患者生活质量评分(SGRQ总分)并分析血清Leptin、IL-6与各营养参数和SGRQ总分间的相关性。结果:1.COPD患者(AECOPD+COPD)的各营养指标:BMI、IBW%、ALB、LMY及SGRQ总分均显著低于对照组(P＜0.01)。2.AECOPD组血清Leptin(2.06±0.6ng/ml)显著高于对照组(1.27±0.7ng/ml)与COPD组(0.72±0.2ng/ml)P＜0.01。COPD组血清Leptin显著低于对照组,P＜0.01。3.AECOPD组血清IL-6浓度(0.71±0.3ng/ml)显著高于COPD组血清IL-6浓度(0.25±0.09ng/ml),而COPD组血清IL-6浓度显著高于对照组(0.09±0.08ng/ml),P＜0.01。4.AECOPD组血清Leptin与各营养指标无显著相关性,与IL-6之间呈显著正相关;COPD组血清Leptin与BMI、IBW%呈显著正相关,与SGRQ和IL-6呈负相关;AECOPD组血清IL-6与营养参数无明显的相关关系;COPD营养不良组、COPD非营养不良组的血清IL-6与BMI、IBW%呈显著负相关,与SGRQ呈正相关。结论:1.COPD患者存在营养不良和生活质量下降。2.Leptin和IL-6可作为AECOPD的炎症标志物。3.Leptin、IL-6可能参与了COPD患者的营养不良,降低了其生活质量。更多还原

【Abstract】 Objectives: To investigate the correlation between the serum leptin levels, interleukin-6 (IL-6) on nutrition states and quality of life in patients with chronic obstructive pulmonary disease (COPD).Methods: 35 COPD patients in acute exacerbations stage; 15 COPD patients in stable stage of malnutrition, 15 COPD patients in stable stage non-malnoutrished and 15 health controls were studied. Height, weight, BMI, IBW%, ALB and LYM were determined. Serum leptin and IL-6 were measured by enzyme-linked immunosorbent assay (ELISA) at the same time. The correlation between leptin, IL-6 nutritional parameters was analysed as well as SGRQ scores.Results: 1. BMI, IBW%, ALB, LYM and SGRQ scores in COPD patients were significantly lower than those in healthy controls (P<0.01). 2. Serum leptin level was significantly higher in AECOPD group (2.06±0.6ng/ml) than that in COPD group (0.72±0.2ng/ml) and healthy controls (1.27±0.7ng/ml) P<0.01. Serum leptin level was significantly lower in COPD group than that in health P<0.01. 3. Serum IL-6 was significantly higher in AECOPD group (0.71±0.3ng/ml) than those in COPD group (0.25±0.09ng/ml). Serum IL-6 was significantly higher in COPD group than those in healthy controls (0.09±0.08ng/ml) P<0.01. 4. Serum leptin in AECOPD group patients showed no significant correlation with BMI, ALB, LYM and IBW%, but showed a positive correlation with serum IL-6. Serum leptin in COPD group showed a positive correlation with BMI and IBW%, a negative correlation with IL-6 and SGRQ scores. Serum IL-6 in AECOPD group showed no significant correlation with nutritional parameters. Serum IL-6 in COPD group showed a negative correlation with BMI and IBW%, a positive correlation with SGRQ scores.Conclusion: Malnutrition was occurred in patient with COPD. Serum leptin level and IL-6 level can be used as an inflammatory marker in AECOPD. Serum leptin levels, IL-6 correlate with nutritional parameters and quality of life in COPD patients and may contribute to the malnutrition in COPD.更多还原