维生素D与COPD患者肺功能及血清炎症因子的相关性

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摘要目的：探讨维生素D与慢性阻塞性肺疾病（COPD）患者肺功能及血清炎症因子之间的关系。方法：收集健康体检者27例，COPD稳定期患者30例，COPD急性加重期患者34例，分别采用电化学发光法测定25-羟基维生素D[25-（OH）D]，ELISA法测定INF-γ、TNF-α，流式细胞技术测定IL-2、IL-4、IL-6、IL-10，比较3组受试者上述指标水平的差异，同时测定3组受试者的第一秒用力呼气容积（FEV1），分别探讨COPD稳定期组和COPD急性加重期组患者血清25-（OH）D与FEV1、INF-γ、TNF-α、IL-2、IL-4、IL-6、IL-10之间的关系。结果：3组患者的血清25-（OH）D水平比较，COPD急性加重期组和COPD稳定期组均低于健康体检组（P＜0.001），COPD急性加重期组低于COPD稳定期组（P＜0.001）。3组的维生素D缺乏患病率比较，COPD急性加重期组与COPD稳定期组均高于健康体检组（P＜0.001），而COPD急性加重期组与COPD稳定期组的患病率差异无统计学意义（P=0.225）。COPD稳定期组的血清25-（OH）D水平与FEV1水平呈正相关（r=0.524，P=0.005）。COPD急性加重期组的血清INF-γ水平较COPD稳定期组高（P＜0.001）；COPD急性加重期组INF-γ及IL-6水平均较健康体检组高（均P＜0.001）；COPD稳定期组IL-2及IL-6水平较健康体检组高（P=0.024和P=0.007）。COPD患者血清25-（OH）D水平与INF-γ、TNF-α和IL-2、IL-4、IL-6、IL-10之间无线性相关性。结论：COPD患者的维生素D缺乏患病率较健康人高，维生素D水平可能与FEV1水平存在正相关，而COPD患者血清25-（OH）D水平与血清炎症因子水平无线性相关性。

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关键词 ：慢性阻塞性肺疾病, 25-羟基维生素D, 第一秒用力呼气容积, 炎症因子

Abstract：Objective: To investigate the relationship between vitamin D and pulmonary function and serum inflammatory factors in patients with COPD. Methods: Twenty-seven healthy subjects, 30 patients with stable COPD and 34 patients with acute exacerbations of COPD were enrolled in our study. Serum level of 25-(OH)D was measured by the ECLIA. The expression of INF-γ and TNF-α were measured by ELISA, and IL-2, IL-4, IL-6, IL-10 were measured by FCM. All these subjects were compared among three groups. All patients of three groups performed pulmonary function tests. Correlations between 25-(OH)D and FEV1, INF-γ, TNF-α and IL-2, IL-4, IL-6, IL-10 were analyzed in stable COPD group and AECOPD group. Results: ①The levels of 25-(OH)D in AECOPD group and stable COPD group were significantly lower than those in control group (P<0.001). The level of 25-(OH)D in AECOPD group was significantly lower than that in stable COPD group (P<0.001). ②The prevalence of Vitamin D deficiency of AECOPD group and stable COPD group were higher than that of the control group (P<0.001), but there was no significant difference between AECOPD group and stable COPD (P=0.225). ③The level of 25-(OH) D was positively correlated with FEV1 in stable COPD group (r=0.524, P=0.005). ④The level of INF-γ of AECOPD group was significantly higher than those in stable COPD group (P<0.001). The level of INF-γ and IL-6 of AECOPD group was significantly higher than those in control group (both P<0.001). The level of IL-2 and IL-6 of stable COPD group was significantly higher than those in control group (P=0.024, P=0.007, respectively). ⑤There was no linear correlation between the level of 25-(OH) D and INF-γ, TNF-α, IL-2, IL-4, IL-6, IL-10 in patients with COPD. Conclusion: Vitamin D deficiency is highly prevalent to COPD patients, and the level of 25-(OH) D may be positively correlated with FEV1, but there was no linear correlation between the level of 25-(OH) D and serum inflammatory factors in patients with COPD.

Key words： COPD 25-(OH)D FEV1 inflammatory factors

收稿日期: 2015-07-02

通讯作者: 戴元荣，主任医师，教授，硕士生导师，Email：daiyr@163.com。

作者简介: 蒋欢欢（1985-），女，浙江永嘉人，主治医师，在职硕士生。

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https://xb.wmu.edu.cn/CN/ 或 https://xb.wmu.edu.cn/CN/Y2016/V46/I2/102

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