【摘要】 目的了解慢性阻塞性肺疾病(COPD)患者炎症发生过程中血清瘦素(leptin)的表达、变化及其与缺氧、CO2潴留、气道阻力的关系。方法选择2002-05～2003-05广州市红十字会医院呼吸科住院COPD患者56例,按病程分为:急性加重期、临床稳定期。在不同时期测定leptin、促红细胞生成素(EPO)、C反应蛋白(CRP)、血清白蛋白(ALB)、动脉血气分析指标,并检测肺功能指标,计算体重指数(BMI)、呼吸频率(R)。选择同期正常对照组20例。结果急性加重期leptin、CRP、ALB、动脉血pH值、PaO2、PaCO2、动脉血氧饱和度(SaO2)、R与临床稳定期比较差异有统计学意义(P<0.01)。急性加重期leptin质量浓度与EPO、ALB、动脉血pH值负相关。与CRP、PaCO2、R、BMI正相关,与肺功能指标中的呼吸总阻抗、总气道阻力、中心气道阻力、中心阻力正相关,与1秒用力呼气容积、20Hz振荡频率时弹性阻力和惯性阻力之和呈负相关。临床稳定期leptin、BMI与正常对照组比较显著降低(P均<0.01)。结论COPD患者急性加重期leptin明显升高,可作为急性加重期的炎性标志物。leptin是导致COPD患者反复感染的危险因素。更多还原

【Abstract】 Objective To investigate the change of leptin expression in various period in the patient with COPD and the association between leptin and anoxia,carbon retention as well as airway resistance .Methods 56 patients with COPD from Department of Respiration,the Red Cross Hospital of Guangzhou were classified as acute exacerbation and stationary phase according to progressing.All patients completed tests of the leptin,EPO（Erythropoietin）,CRP（C-reactive protein）,ALB（serum albumin）,arterial gas analysis,pulmonary function,counting BMI and R .The control group included 20 people.Results The leptin,CRP,ALB,arterial PH,PaCO₂,PaO₂,SaO₂ and R were significantly different between the acute exacerbation phase and stationary phase in the patients with COPD（P<0.05 and P[WTBZ]<0.01）.The levels of leptin was negatively correlated with EPO,ALB,arterial PH,and FEV₁、reactance at 20 Hz in pulmonary function parametersin acute exacerbation phase。It was positively correlated with CRP、PaCO₂、R、BMI,and total impedance of the respiratory system（Zres）,respiratory resistance at 5 Hz,20 Hz,centric resistance in pulmonary function parametersin acute exacerbation phase.The leptin and BMI was significantly lower in stationary phase in patients with COPD than that in control group（P<0.01）.Conclusion The leptin is an inflaming mark of the acute exacerbation phase in the patients with COPD.The leptin can be a risk factor of repeating the infection.更多还原