目的探究不同严重程度男性慢性阻塞性肺疾病(COPD)患者血清睾酮水平变化的临床意义。方法收治的120例男性COPD患者为研究对象,按病情程度分为轻度组35例、中度组48例、重度组37例。患者就诊当日完成一般资料、病史信息采集及急性生理学和慢性健康(APACHE II)评分评估,于次日清晨入院采血检测血清睾酮水平,并通过测定第1秒用力呼气容积(FEV1)、用力肺活量(FVC)评估肺功能及痰液IL-8、TNF-α水平评估气道炎症反应。结果轻度组、中度组、重度组患者性别、年龄、病程比较无统计学意义(P>0.05),但APACHE II评分轻度组<中度组<重度组,血清睾酮水平轻度组>中度组>重度组,差异有统计学意义(P<0.05)。肺功能指标FEV1、FVC轻度组>中度组>重度组,气道炎症因子IL-8、TNF-α水平轻度组<中度组<重度组,差异均有统计学意义(P <0.05)。Spearman相关性分析显示男性COPD患者血清睾酮水平与APACHE II评分,痰上清液IL-8、TNF-α水平呈负相关(P <0.05),与FEV1、FVC呈正相关(P <0.05)。结论男性COPD患者血清睾酮水平随病情严重程度呈递减状态,并与肺功能及气道炎症反应密切相关。
Objective To explore clinical significance of serum testosterone levels in patients with different severity of chronic obstructive pulmonary disease(COPD). Methods Total of 120 male patients with COPD were divided into three groups including the mild group(35 cases), the moderate group(48 cases) and the severe group(37 cases). The general data,medical history and acute physiology and chronic health examination(APACHE II) were evaluated on the day of treatment.The serum testosterone level was measured in the morning of the next day. The forced expiratory volume in 1 second(FEV1)and forced vital capacity(FVC) were determined to evaluate the lung function, and levels of sputum interleukin-8(IL-8) and tumor necrosis factor(TNF-α) were determined to evaluate the airway inflammatory response. Results There was no significant difference among the mild group, moderate group and severe group in gender, age or course of disease(P > 0.05).The APACHE II score showed mild group < moderate group < severe group, while the serum testosterone levels showed mild group > moderate group > severe group(P < 0.05). Lung function indexes FEV1 and FVC showed mild group > moderate group > severe group, while levels of airway inflammatory factors IL-8 and TNF-α showed mild group < moderate group
引文
1王威,马清峰.老年肺癌患者性激素水平的变化及意义中国老年学2016;36(5):1223-1224
2魏珍星,常昆鹏.成年男性OSAHS患者血清睾酮水平的研究.中国耳鼻咽喉颅底外科杂志2017;23(3):222-225
3 Price D B,Baker C L,Zou K H,et al.Real-world characterization and differentiation of the Global Initiative for Chronic Obstructive Lung Disease strategy classification.I nter Chronic Obstructive Pulmonary Disease 2014;9(19):551-61
4中华医学会呼吸病学分会慢性阻塞性肺疾病学组.慢性阻塞性肺疾病诊治指南(2013年修订版).中华结核和呼吸杂志2013;36(4):715-717
5金哲,王广发.慢性阻塞性肺疾病全球倡议(2014更新版)解读.中国医学前沿杂志:电子版2014;6(2):94-97
6蔡柏蔷.慢性阻塞性肺疾病诊断、处理和预防全球策略(2017 GOLD报告)解读.国际呼吸杂志2017;37(1):6-17
7 Tinkelman D G,Price D B,Nordyke R J,et al.Misdiagnosis of COPD and Asthma in Primary Care Patients 40 Years of Age and Over.J Asthma Res 2016;43(1):75-80
8蒋衣果,周梅芳,朱建军,等.辛伐他汀联合法舒地尔治疗COPD合并肺动脉高压患者临床效果观察.西部医学2016;28(5):709-712
9徐瑜,罗百灵.慢性阻塞性肺疾病急性加重期患者血清hs-CRP、CA-125和IL-6水平变化及临床意义.临床肺科杂志2017;22(3):458-460
10范培云,周环,刘佳佳.老年男性2型糖尿病合并冠心病患者血清睾酮和脂联素水平变化的临床研究.重庆医学2017;46(11):1469-1471
11薛青,焦维克,邓新宇,等.COPD合并勃起功能障碍的调查研究.临床肺科杂志2014;19(9):1572-1575
12张清华,李仙凤,曹丽华.血清性激素水平在肺癌早期诊断中的意义.医学与哲学2016;37(22):36-39
13罗广彬.血浆BNP水平和血清hs-CRP水平检测在不同程度COPD中临床应用.国际检验医学杂志2017;38(6):838-840
14 Abbasi M,Zohal M,Atapour B,et al.Prevalence of Osteoporosis and Its Risk Factors in Men with COPD in Qazvin.Inter J Chronic Dis 2016;2016(6):1-6
15张未,关蔚蔚,姜静.老年男性慢性阻塞性肺疾病患者并发骨质疏松症与血清睾酮水平的关系.中华骨质疏松和骨矿盐疾病杂志2017;10(6):535-540