文章摘要
于凡珍,李家树.慢性阻塞性肺疾病患者血浆锁链素、维生素K水平变化及临床意义[J].安徽医药,待发表.
慢性阻塞性肺疾病患者血浆锁链素、维生素K水平变化及临床意义
投稿时间:2021-12-23  录用日期:2022-01-14
DOI:
中文关键词: 慢性阻塞性肺疾病  锁链素  维生素K  非活性基质Gla蛋白  炎性因子  肺功能
英文关键词: 
基金项目:连云港市科技项目(SH1401)
作者单位邮编
于凡珍 连云港市第一人民医院 222000
李家树 连云港市第一人民医院 
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中文摘要:
      目的 探讨慢性阻塞性肺疾病(COPD)患者血浆锁链素(DES)、维生素K水平变化及临床意义。方法 选取2020年12月至2021年7月在徐州医科大学附属连云港医院就诊的COPD患者60例为COPD组,同期健康体检者30例为对照组。检测并比较两组血DES、维生素K、白细胞介素(IL-6)、肿瘤坏死因子(TNF-α)、第一秒用力呼气容积占预计值百分比(FEV1%)、一氧化氮弥散量(DLCO),其中维生素K通过测量血浆非活性基质Gla蛋白(Dp-ucMGP)水平来评估;采用Pearson分析血浆DES、维生素K水平与IL-6、TNF-α、FEV1%、DLCO的相关性。结果 COPD组患者血DES、Dp-ucMGP、IL-6、TNF-α水平[(3.03±0.96)ng/mL、(11.24±1.45)ng/mL、(3.97±1.91)pg/mL和(6.19±3.17)pg/mL]均高于对照组[(1.83±0.89)ng/mL、(8.93±1.78)ng/mL、(2.45±1.41)pg/mL和(2.95±1.79)pg/mL](P < 0.05),肺功能指标FEV1%、DLCO[(53.44±16.43)%和(4.31±1.29)mmol/min/kPa]均显著低于对照组[(81.65±11.46)%和(6.22±0.94)mmol/min/kPa](P < 0.05)。根据不同进展期分组,AECOPD组患者血浆DES、Dp-ucMGP水平[(2.97±0.99)ng/mL、(11.35±1.50)ng/mL]与COPD稳定期组[(3.08±0.94)ng/mL、(11.14±1.42)ng/mL]比较,差异无统计学意义(P > 0.05)。AECOPD组患者血清IL-6、TNF-α水平[(4.45±2.13)pg/mL、(8.01±2.65)pg/mL]明显高于COPD稳定期组[(3.48±1.56)pg/mL、(4.38±2.56)pg/mL](P < 0.05),肺功能指标FEV1%、DLCO[(49.17±13.99)%、(3.80±0.97)mmol/min/kPa]明显低于COPD稳定期组[(57.72±17.77)%、(4.82±1.37)mmol/min/kPa](P < 0.05)。根据不同急性加重风险分组,COPD高风险组患者血浆DES、Dp-ucMGP、IL-6水平[(3.68±0.71)ng/mL、(11.88±1.27)ng/mL、4.37(4.01,6.13)pg/mL]均明显高于COPD低风险组[(2.49±0.79)ng/mL、(10.72±1.40)ng/mL、2.70(1.72,4.01)pg/mL](P < 0.05),肺功能指标FEV1%、DLCO[(47.12±14.58)%和(3.88±1.24)mmol/min/kPa]均明显低于COPD低风险组[(58.61±16.24)%和(4.66±1.23)mmol/min/kPa](P < 0.05)。Pearson相关性分析显示,COPD患者血浆DES、Dp-ucMGP水平与FEV1%、DLCO均呈显著负相关(P < 0.05),与血清IL-6、TNF-α水平均呈显著正相关(P < 0.05);COPD患者血浆DES与Dp-ucMGP呈显著正相关(P < 0.05),即与维生素K呈显著负相关(P < 0.05)。结论 COPD患者的血浆DES、Dp-ucMGP水平均明显升高,并与炎性因子升高和肺功能下降有关,可作为COPD患者病情评估的生化指标;COPD患者血浆维生素K水平降低,可能通过影响肺弹性蛋白降解参与COPD的发生发展。
英文摘要:
      Objective To investigate the changes and clinical significance of plasma desmosine (DES) and vitamin K levels in patients with chronic obstructive pulmonary disease(COPD).Methods Sixty patients with COPD who were treated in Lianyungang Hospital Affiliated to Xuzhou Medical University from December 2020 to July 2021 were selected as the COPD group, and 30 patients with healthy physical examination during the same period were selected as the control group.Detect and compare the groups of blood DES,vitamin K,interleukin (IL)-6,tumor necrosis factor (TNF-α),forced expiratory volume in the fi-rst second to predicted value ratio(FEV1%),and diffusion capacity for carbon monoxide of lung(DLCO),of which vitamin K was assessed by measuring the plasma inactive matrix Gla protein (Dp-ucMGP) level.Pearson was used to analyze the correlation between plasma DES and vitamin K levels with IL-6,TNF-α,FEV1%,and DLCO.Results The levels of blood DES, Dp-ucMGP, IL-6, and TNF-α[(3.03±0.96)ng/mL,(11.24±1.45)ng/mL,(3.97±1.91)pg/mL and (6.19±3.17)pg/mL]in the COPD group were higher than those in the control group[(1.83±0.89)ng/mL,(8.93±1.78)ng/mL,(2.45±1.41)pg/mL and (2.95±1.79)pg/mL](P < 0.05), and the lung function indexes FEV1% and DLCO[(53.44±16.43)% and (4.31±1.29)mmol/min/kPa] were significantly lower than those in the control group[(81.65±11.46)% and (6.22±0.94)mmol/min/kPa](P < 0.05).Grouped according to different stages of progression, there was no statistically significant difference in plasma DES and Dp-ucMGP levels between the AECOPD group[(2.97±0.99)ng/mL,(11.35±1.50)ng/mL] and the COPD stable group[(3.08±0.94)ng/mL,(11.14±1.42)ng/mL](P > 0.05).The levels of serum IL-6 and TNF-α[(4.45±2.13)pg/mL,(8.01±2.65)pg/mL]in the AECOPD group were significantly higher than those in the stable COPD group[(8.01±2.65)ng/mL,(11.14±1.42)ng/mL](P < 0.05), and the lung function indexes FEV1% and DLCO[(49.17±13.99)% and (3.80±0.97)mmol/min/kPa]were significantly lower than those in the stable COPD group[(57.72±17.77)% and (4.82±1.37)mmol/min/kPa](P < 0.05).According to different acute exacerbation risk groups, the blood DES, Dp-ucMGP, and IL-6 levels of the COPD high-risk group[(3.68±0.71)ng/mL,(11.88±1.27)ng/mL and 4.37(4.01,6.13) pg/mL] were significantly higher than those of the COPD low-risk group[(2.49±0.79)ng/mL,(10.72±1.40)ng/mL and 2.70(1.72, 4.01)pg/mL](P < 0.05), and the lung function indexes FEV1% and DLCO[(47.12±14.58)% and (3.88±1.24)mmol/min/kPa] were significantly lower than the COPD low-risk group[(58.61±16.24)% and (4.66±1.23)mmol/min/kPa](P < 0.05). Pearson correlation analysis showed that plasma DES and Dp-ucMGP levels in COPD patients were significantly negatively correlated with FEV1% and DLCO (P < 0.05),and significantly positively correlated with serum IL-6 and TNF-α levels (P < 0.05).Plasma DES in COPD patients was significantly positively correlated with Dp-ucMGP (P <0.05),and significantly negatively correlated with vitamin K (P < 0.05).Conclusions The plasma DES and Dp-ucMGP levels of COPD patients are significantly increased,which are related to the increase of inflamatory factors and the decline of lung function,which can be used as biochemical indicators for the evaluation of the condition of COPD patients.The plasma vitamin K level in patients with COPD is reduced, and it may participate in the occurrence and development of COPD by affecting the degradation of lung elastin.
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