摘要
目的研究慢性阻塞性肺疾病 (COPD)患者缺氧对TNF α系统的激活及与营养不良的关系 ,探讨COPD营养不良的发生机制。方法研究对象为 2 7例COPD稳定期患者及 2 9名正常人 ,COPD患者分为Ⅰ组 (营养不良组 ) 1 2例 ,Ⅱ组 (非营养不良组 ) 1 5例 ,测定其血清可溶性肿瘤坏死因子受体 5 5 (sTNF R5 5 )浓度、体重指数 (BMI)、理想体重百分比 (NW % )、体脂百分比 (fat% )、上臂中部臂围 (MAC)、血清白蛋白(ALB)、总淋巴细胞计数 (LYM) ,对COPD稳定期患者加测动脉血气分析。血清sTNF R5 5浓度通过酶联免疫吸附实验 (ELISA)法检测 ,并分析COPD患者血清sTNF R5 5浓度与动脉血氧分压 (PO2 )、营养参数之间的相关性。结果①COPD稳定期患者BMI、NW %、fat%、MAC、ALB、LYM均显著低于正常对照组 (P <0 .0 1 ) ,血清sTNF R5 5浓度显著高于正常对照组 (P <0 .0 5 ) ;②Ⅰ组年龄、血清sTNF R5 5浓度均显著高于对照组 (P <0 .0 5 ) ,BMI、NW %、fat%、MAC、ALB、LYM均显著低于对照组 (P <0 .0 1 ) ,Ⅰ组BMI、NW %、fat %、MAC、ALB、LYM也显著低于Ⅱ组 (P <0 .0 1 ) ;③Ⅰ组血清sTNF R5 5浓度与PO2 、BMI、NW %、fat%、ALB呈显著负相关 (P <0 .0 5 ) ;④COPD患者血清sTNF R5 5浓度与年龄呈正相关 。
ObjectivesTo investigate the correlation between hypoxia activating the tumor necrosis factor α(TNF α) system in patients with chronic obstructive pulmonary disease (COPD) and their malnutrition as well as to explore the pathogenesis.MethodsTwenty seven COPD patients in stable stage and 29 healthy controls were studied. COPD patients were divided into two groups :①Group I, 12 malnourished cases and ②Group II, 15 cases without malnutrition. Serum levels of soluble TNF receptor 55(sTNF R55), body mass index (BMI), percentage of normal body weight (NW%), percentage of body fat (fat%),mid upper arm circumference (MAC),serum albumin levels(ALB) and total lymphocyte counts(LYM) were measured. Arterial blood gas analysis was carried out in COPD patients. Serum sTNF R55 levels were detected by enzyme linked immunosorbent assay (ELISA). The correlations between serum sTNF R55 levels and arterial blood partial pressure of oxygen (PO 2) /nutritional parameters were analyzed.Results①BMI, NW%, fat%, MAC, ALB and LYM in stable COPD patients were significantly lower than those in healthy controls (P<0.01) , whereas their serum sTNF R55 levels were significantly higher than those in healthy controls(P<0.05) ; ②The age and serum sTNF R55 levels in Group I were distinctly higher than those in healthy controls(P< 0.05 ), while their BMI, NW%, fat% ,MAC, ALB and LYM were obviously lower than those in healthy controls and Group Ⅱ(P<0.01 ). ③A significant negative correlation existed between serum sTNF R55 levels in Group I and results of their PO 2 , BMI, NW%, fat% and ALB (P<0.05); ④Serum sTNF R55 levels in COPD patients were positively correlated with their age, but this was not found in healthy controls.ConclusionHypoxia may activate the TNF α system in COPD patients and takes part in the development of malnutrition.
出处
《医学临床研究》
CAS
2003年第12期881-884,共4页
Journal of Clinical Research
关键词
肺疾病
阻塞性
肿瘤坏死因子
低氧
营养障碍
lung diseases,obstructive
tumor necrosis factor
anoxia
nutrition disorders
