摘要
目的分析高血糖对慢性阻塞性肺疾病急性加重期(aceute exacerbation of chronic obstructive pulmonary disease,AECOPD)患者血清炎性因子和肺功能的影响及相关性。方法选取我院2015年3月—2016年4月收治的150例AECOPD患者,根据入院时空腹血糖水平分为AECOPD正常血糖组(90例)与AECOPD高血糖组(60例)。分析两组血清炎性因子[白细胞介素6(IL-6)、肿瘤坏死因子α(TNF-α)、C反应蛋白(CRP)]水平与肺功能指标[第1秒用力呼气容积(FEV 1)、FEV 1/用力肺活量(FVC)、肺一氧化碳弥散量(DLCO)、肺总量(TLC)、残气量(RV)/TLC]差异,并分析AECOPD患者空腹血糖、血清炎性因子、肺功能指标之间的相关性。结果AECOPD正常血糖组TNF-α、IL-6、CRP水平明显低于AECOPD高血糖组,差异有统计学意义(P<0.01);AECOPD正常血糖组TLC、RV/TLC、FEV 1、DLCO及FEV 1/FVC值均明显高于AECOPD高血糖组,差异均有统计学意义(P<0.01);AECOPD患者血清炎性因子IL-6、TNF-α、CRP水平与空腹血糖水平呈正相关,而与肺功能指标FEV 1和FEV 1/FVC呈负相关,且空腹血糖水平与FEV 1和FEV 1/FVC亦呈负相关。结论与AECOPD血糖正常患者相比,AECOPD高血糖患者血清炎性因子明显升高,肺功能明显下降,且随着血糖水平和炎性因子水平的升高,患者肺功能越差。
Objective To analyze the effect of hyperglycemia on serum inflammatory factors and pulmonary function in patients with acute exacerbation of chronic obstructive pulmonary disease(AECOPD)and their correlation.Methods A total of 150 patients with AECOPD admitted to our hospital from March 2015 to April 2016 were selected.According to the level of fasting blood sugar at admission,the patients were divided into AECOPD normal blood sugar group(n=90)and AECOPD hyperglycemia group(n=60).The differences in the levels of serum inflammatory factors[interleukin-6(IL-6),tumor necrosis factorα(TNF-α),C-reactive protein(CRP)]and lung function indicators[slow vital capacity(SVC),forced vital capacity(FVC),forced expiratory volume in 1 second(FEV 1),FEV 1/forced vital capacity(FVC),diffusion capacity of carbon monoxide(DLCO),total lung capacity(TLC),residual volume(RV)/TLC]were analyzed between the two groups.The correlation between fasting blood glucose level,serum inflammatory factor and lung function indexes in AECOPD patients was analyzed.Results The levels of TNF-α,IL-6 and CRP in AECOPD normal blood glucose group were significantly lower than those in AECOPD hyperglycemia group(P<0.01).The TLC,RV/TLC,FEV 1,DLCO,and FEV 1/FVC levels of AECOPD normal blood glucose group were significantly higher than those of AECOPD hyperglycemia group(P<0.01).Serum inflammatory factor IL-6,TNF-αand CRP levels in AECOPD patients were positively correlated with fasting blood glucose levels,but negatively correlated with indicators of lung function(FEV 1,FEV 1/FVC).In addition,fasting blood glucose levels were negatively correlated with FEV 1 and FEV 1/FVC levels.Conclusion Compared with COPD patients with normal blood glucose,COPD patients with hyperglycemia had significantly higher serum inflammatory factors and lower lung function,and blood glucose level was positively correlated with serum inflammatory factors and related indicators of lung function.Meanwhile,higher levels of inflammatory factors led to worse pulmonary function of patients.
作者
吕侯强
谢轩
范素芳
LYU Hou-qiang;XIE Xuan;FAN Su-fang(Department of Respiratory Medicine,the Second Hospital of Shijiazhuang,Shijiazhuang 050051,China)
出处
《临床误诊误治》
2020年第1期45-49,共5页
Clinical Misdiagnosis & Mistherapy
基金
河北省医学科学研究重点课题(20181037)
关键词
肺疾病
慢性阻塞性
血糖
白细胞介素6
肿瘤坏死因子Α
肺活量
第1秒用力呼气容积
Pulmonary disease
chronic obstructive
Blood glucose
Interleukin-6
Tumor necrosis factor-alpha
Vital capacity
Forced expiratory volume in one second
