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目的初步探讨慢性阻塞性肺疾病(COPD)患者血浆食欲素A质量浓度的变化及临床意义。方法选择江苏省镇江市第四医院呼吸内科2004年6月至2004年11月伴有肥胖的COPD患者15例、不伴有肥胖的COPD患者20例、单纯肥胖者20例和健康成人20名。其中肥胖COPD组和单纯肥胖组的体重指数(BMI)均大于25,两组之间BMI差异无统计学意义。所有受试者均接受肺功能检查及血气分析,采用层析方法将血浆去蛋白化处理及放射免疫分析法测定4组血浆食欲素A的水平。结果血浆食欲素A的质量浓度肥胖COPD组[(8.82±1.90)ng/L]与非肥胖COPD组[(8.69±1.84)ng/L]显著高于单纯肥胖组[(7.18±1.45)ng/L(P<0.01)]及正常对照组[(6.72±1.58)ng/L(P<0.01)]。肥胖COPD组与非肥胖COPD组血浆食欲素A差异无显著性意义(P>0.05)。肥胖与非肥胖COPD组检测指标相关分析显示血浆食欲素A质量浓度与动脉血氧分压(PaO2)(r=-0.527,P<0.01)、血氧饱和度(SaO2)(r=-0.529,P<0.01)呈负相关,而与动脉血二氧化碳分压(PaCO2)、1秒用力呼气容量(FEV1)占预计值的百分比以及BMI、脂肪百分比(%fat)无相关性。结论COPD患者血浆食欲素A质量浓度升高,其原因可能与COPD患者气道阻塞所致低氧血症及其病理生理变化有关。
Objective To investigate the changes of plasma orexin A concentration in patients with chronic obstructive pulmonary disease (COPD) and its clinical significance. Methods A total of 15 COPD patients with obesity, 20 patients without obesity, 20 obesity patients and 20 healthy adults were enrolled in this study. The body mass index (BMI) in obese COPD group and simple obesity group were both greater than 25, and there was no significant difference in BMI between the two groups. All subjects underwent pulmonary function tests and blood gas analysis. The levels of plasma orexin-A in four groups were determined by chromatographic deproteinization and radioimmunoassay. Results The plasma concentration of orexin A in obese COPD group was significantly higher than that in obese COPD group [(8.82 ± 1.90) ng / L vs (8.69 ± 1.84) ng / L vs (7.18 ± 1.45) ng / L (P <0.01)] and normal control group [(6.72 ± 1.58) ng / L, P <0.01]. There was no significant difference in plasma orexin A between obese COPD group and non-obese COPD group (P> 0.05). Correlation analysis between the indexes of obesity and non-obese COPD showed that plasma concentrations of orexin-A and PaO2 (r = -0.527, P <0.01), SaO2 (r = -0.529, P <0.01), and had no correlation with arterial partial pressure of carbon dioxide (PaCO2), forced expiratory volume in one second (FEV1), percentage of predicted value, and percentage of BMI and% fat. Conclusion The plasma concentration of orexin A in COPD patients may be related to hypoxemia and pathophysiological changes caused by airway obstruction in COPD patients.