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目的研究慢性阻塞性肺疾病急性加重期(acute exacerbation of chronic obstructive pulmonary disease,AECOPD)患者血标本中25(OH)D的变化与白介素6(Interleukin 6,IL-6)、免疫球蛋白A(Immunoglobulin A,Ig A)的关系。方法选取AECOPD患者72例,正常对照组58例,测定并比较2组间血清25(OH)D水平。根据AECOPD患者的血清25(OH)D水平将其分为2组,维生素D缺乏组和维生素D正常组,测定此2组研究对象的血清IL-6、Ig A水平,比较2组间的差异。结果 AECOPD病例组的血清25(OH)D水平,显著低于健康对照组(t=2.04,P<0.05)。AECOPD患者中维生素D缺乏组的血清IL-6水平明显高于维生素D正常组(P<0.05),缺乏组中Ig A水平明显低于维生素D正常组(P<0.05)。通过线性回归分析发现IL-6、Ig A与AECOPD患者血清25(OH)D水平呈显著相关(P<0.05)。结论 AECOPD患者25-羟维生素D水平与IL-6、Ig A存在相关关系。IL-6水平与25-羟维生素D水平呈负相关(P<0.05),Ig A水平与25-羟维生素D水平呈正相关(P<0.01)。血清25-羟维生素D的缺乏可能通过加重COPD的全身炎症反应导致AECOPD的发生。
Objective To investigate the changes of 25 (OH) D in blood samples of patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD) and the changes of Interleukin 6 (IL-6), Immunoglobulin A, Ig A). Methods 72 patients with AECOPD and 58 normal controls were enrolled in this study. Serum 25 (OH) D levels were measured and compared between two groups. According to the level of serum 25 (OH) D in AECOPD patients, they were divided into two groups: vitamin D deficiency group and vitamin D normal group. The levels of serum IL-6 and IgA in the two groups were measured and compared between two groups . Results Serum 25 (OH) D levels in AECOPD patients were significantly lower than those in healthy controls (t = 2.04, P <0.05). Serum levels of IL-6 in patients with AECOPD were significantly higher than those in patients with normal vitamin D (P <0.05), and levels of IgA in patients with AECOPD were significantly lower than those in patients with normal vitamin D (P <0.05). Linear regression analysis showed that serum IL-6, Ig A and serum 25 (OH) D levels were significantly correlated with AECOPD (P <0.05). Conclusion The level of 25-hydroxyvitamin D in patients with AECOPD is correlated with the levels of IL-6 and IgA. The level of IL-6 was negatively correlated with 25-hydroxyvitamin D (P <0.05), while the level of IgA was positively correlated with 25-hydroxyvitamin D (P <0.01). The lack of serum 25-hydroxyvitamin D may lead to the development of AECOPD by exacerbating the systemic inflammatory response to COPD.