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目的探讨3种不同体重指数(BMI)稳定期慢性阻塞性肺疾病(简称慢阻肺)患者血清瘦素、肿瘤坏死因子α(TNF-α)、白细胞介素8(IL-8)及超敏C反应蛋白(hs-CRP)水平是否有差异。方法将稳定期慢阻肺患者105例按BMI进行分组:BMI<18.5 kg/m2的32例为低BMI组,BMI 18.5~23.9 kg/m2的48例为正常BMI组,BMI≥23.9 kg/m2的25例为高BMI组。同时将BMI为18.5~23.9 kg/m2的健康体检者30例作为健康对照组。用放免法检测各组受试者血清中瘦素、TNF-α、IL-8水平;全自动生化分析仪测定hs-CRP。结果慢阻肺患者瘦素水平[(10.19±4.63)ng/L]低于健康对照组[(14.12±4.86)ng/L(P<0.05)],其中低BMI组及高BMI组患者瘦素水平[(7.89±3.16)ng/L,(10.52±5.98)ng/L]低于正常BMI组[(13.04±5.73)ng/L,P<0.05],低BMI组较高BMI组下降更显著(P<0.05)。慢阻肺患者TNF-α水平[(192.37±83.65)μg/L]较健康对照组[(178.59±60.38)μg/L]增高(P<0.05),其中低BMI组TNF-α水平[(229.39±89.57)μg/L]高于高BMI组[(189.46±82.41)μg/L]及正常BMI组[(180.06±74.24)μg/L,P<0.01]。3组慢阻肺患者之间IL-8水平无明显差异。高BMI组hs-CRP水平较低BMI组(P<0.01)及正常BMI组明显升高(P<0.05)。结论不同BMI的慢阻肺患者瘦素水平有不同程度的降低,瘦素、TNF-α参与了稳定期慢阻肺患者低体重的发生。
Objective To investigate the changes of serum leptin, tumor necrosis factor-α (TNF-α), interleukin 8 (IL-8) and hypersensitivity in three kinds of patients with chronic obstructive pulmonary disease (BMI) C-reactive protein (hs-CRP) levels are different. Methods A total of 105 patients with stable COPD were divided into two groups based on BMI: 32 patients with BMI <18.5 kg / m2 had low BMI, 48 patients with BMI 18.5-23.9 kg / m2 had normal BMI, BMI≥23.9 kg / m2 25 cases of high BMI group. Meanwhile, 30 healthy subjects with BMI of 18.5-23.9 kg / m2 were selected as healthy control group. Serum levels of leptin, TNF-α and IL-8 were detected by radioimmunoassay. Hs-CRP was measured by automatic biochemical analyzer. Results The levels of leptin in COPD patients [(10.19 ± 4.63) ng / L] were significantly lower than those in healthy controls [(14.12 ± 4.86) ng / L, P < The level of [(7.89 ± 3.16) ng / L, (10.52 ± 5.98) ng / L] was significantly lower than that of the normal BMI group [(13.04 ± 5.73) ng / L, P < (P <0.05). The levels of TNF-αin COPD patients [(192.37 ± 83.65) μg / L] were significantly higher than those in healthy controls [(178.59 ± 60.38) μg / L, P < ± 89.57) μg / L] were higher than those in the high BMI group [(189.46 ± 82.41) μg / L] and the normal BMI group [(180.06 ± 74.24) μg / L, P <0.01]. There was no significant difference in IL-8 level between the three groups of COPD patients. The hs-CRP level in high BMI group was significantly lower than that in BMI group (P <0.01) and normal BMI group (P <0.05). Conclusions Leptin level in COPD patients with different BMI is decreased to a certain extent. Leptin and TNF-α are involved in the low-body weight of COPD patients.