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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。
Objective To investigate the expression and changes of serum leptin in patients with chronic obstructive pulmonary disease (COPD) and its relationship with hypoxia, CO2 retention and airway resistance. Methods Fifty-six COPD patients admitted to Respiratory Department of Guangzhou Red Cross Hospital from May 2002 to May 2003 were divided into acute exacerbation and stable clinical period. The levels of leptin, erythropoietin (EPO), C-reactive protein (CRP), serum albumin (ALB) and arterial blood gas were measured at different time points and lung function indexes were measured. Body mass index (BMI), respiratory rate ). Select the same period the normal control group of 20 cases. Results The leptin, CRP, ALB, arterial blood pH, PaO2, PaCO2, SaO2, R in acute exacerbation were significantly different from those in clinical stable phase (P <0.01). Acute exacerbation of leptin concentration and EPO, ALB, arterial blood pH negative correlation. Positive correlation with CRP, PaCO2, R, BMI, positive correlation with respiratory resistance, total airway resistance, central airway resistance and central resistance in pulmonary function parameters, forced expiratory volume of 1 second, elastic resistance at 20Hz oscillation frequency And the sum of inertial resistance was negatively correlated. Clinical stable phase leptin, BMI and normal control group were significantly lower (P all <0.01). Conclusions The acute lengthening of acute lengthening of leptin in COPD patients can be used as inflammatory markers in acute exacerbation. Leptin is a risk factor for recurrent infections in COPD patients.