| 于凡珍,陈烁,李家树.慢性阻塞性肺疾病60 例血浆锁链素、维生素K 水平变化及临床意义[J].安徽医药,2023,27(3):475-480. |
| 慢性阻塞性肺疾病60 例血浆锁链素、维生素K 水平变化及临床意义 |
| Changes and clinical significance of plasma desmosine and vitamin K in 60 patients with chronic obstructive pulmonary disease |
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| DOI：10.3969/j.issn.1009-6469.2023.03.012 |
| 中文关键词: 肺疾病，慢性阻塞性 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: Pulmonary disease, chronic obstructive Desmosine Vitamin K Dephospho-un-carboxylated matrix Gla protein Inflammatory factors Lung function |
| 基金项目:连云港市科技项目(SH1401)；北京医卫健康公益基金会(YWJKJJHKYJJ-HX11) |
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| 中文摘要: |
| 目的 探讨慢性阻塞性肺疾病(COPD)病人血浆锁链素、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病人60例为COPD组，同期健康体检者30例为对照组。检测并比较两组血锁链素、维生素K、白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)、第1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分析血浆锁链素、维生素K水平与IL-6、TNF-α、FEV1%、DLCO的相关性。结果 COPD组病人血锁链素［(3.03±0.96)μg/L比(1.83±0.89)μg/L］、Dp-ucMGP［(11.24±1.45)μg/L比(8.93±1.78)μg/L］、IL-6、TNF-α水平均高于对照组(P<0.05)，肺功能指标FEV1%、DLCO均显著低于对照组(P<0.05)。根据不同进展期分组，30例AECOPD组病人血浆锁链素、Dp-ucMGP水平与30例COPD稳定期组比较，差异无统计学意义(P>0.05)。AECOPD组病人血清IL-6、TNF-α水平明显高于COPD稳定期组(P<0.05)，肺功能指标FEV1%、DLCO明显低于COPD稳定期组(P<0.05)。根据不同急性加重风险分组，27例COPD高风险组病人血浆锁链素［(3.68±0.71)μg/L比(2.49±0.79)μg/L］、Dp-ucMGP［(11.88±1.27)μg/L比(10.72±1.40)μg/L］、IL-6水平均明显高于33例COPD低风险组(P<0.05)，肺功能指标FEV1%、DLCO均明显低于COPD低风险组。Pearson相关性分析显示，COPD病人血浆锁链素、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病人血浆锁链素与DpucMGP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病人的血浆锁链素、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病人病情评估的生化指标；COPD病人血浆维生素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 pa?tients with chronic obstructive pulmonary disease (COPD).Methods Sixty patients with COPD who were treated in Lianyungang Hos?pital Affiliated to Xuzhou Medical University from December 2020 to July 2021 were selected as the COPD group, and 30 healthy indi?viduals taking physical examination during the same period were selected as the control group. Blood DES, vitamin K, interleukin (IL)-6,tumor necrosis factor (TNF-α),forced expiratory volume in the first second to predicted value ratio (FEV1%),and diffusion capacity for carbon monoxide of lung (DLCO) were detected and compared,of which vitamin K was assessed by measuring the plasma inactive ma?trix Gla protein (Dp-ucMGP) level. Pearson test 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 plasma DES [(3.03±0.96) μg/L vs. (1.83±0.89) μg/L], Dp-ucMGP [(11.24±1.45) μg/L vs. (8.93±1.78) μg/L], IL-6, and TNF-α in the COPD group were higher than those in the control group (P<0.05), and the lung func?tion indexes FEV1% and DLCO were significantly lower in the COPD group than in the control group (P<0.05). When patients were grouped according to different stages of progression, there was no statistically significant difference in plasma DES and Dp-ucMGP lev?els between the AECOPD group (n=30) and the COPD stable group (n=30) (P>0.05).The levels of serum IL-6 and TNF-α in the AECO?PD group were significantly higher than those in the stable COPD group (P<0.05), and the lung function indexes FEV1% and DLCO ferent acute exacerbation risks, the plasma DES [(3.68±0.71) μg/L vs. (2.49±0.79) μg/L], Dp-ucMGP [(11.88±1.27) μg/L vs. (10.72±1.40) μg/L], and IL-6 levels of the COPD high-risk group (n=27) were significantly higher than those of the COPD low-risk group (n=33) (P<0.05), and the lung function indexes FEV1% and DLCO were significantly lower in the COPD high-risk group than in the COPD low-risk group (P<0.05). Pearson correlation analysis results showed that plasma DES and DpucMGP levels in COPD patients were sig?nificantly negatively correlated with FEV1% and DLCO (P<0.05),but significantly positively correlated with serum IL-6 and TNF-α lev?els (P<0.05).Plasma DES in COPD patients was significantly positively correlated with Dp-ucMGP (P<0.05),but significantly negatively correlated with vitamin K (P<0.05).Conclusions The significantly increased plasma DES and Dp-ucMGP levels of COPD patientsare related to the increase of inflammatory 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 reduced, which may participate in the occurrence and development of COPD by affecting the degradation of lung elastin. |
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