慢性阻塞性肺疾病稳定期患者肺功能、营养状况及氧化应激能力分析
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摘要
目的探讨慢性阻塞性肺疾病(COPD)稳定期患者肺功能、营养状况及氧化应激能力。方法选择65例COPD患者设为观察组,另选择35名健康体检者设为对照组。比较2组脂联素和肺功能水平,采用微型营养评定(MNA)进行营养评估,并检测血清还原型谷胱甘肽(GSH)、丙二醛(MDA)、超氧化物歧化酶(SOD)和总抗氧化能力(TAC)水平。结果观察组脂联素水平显著低于对照组,肺功能指标第1秒用力呼气容积占预计值百分比(FEV_1%)、肺活量(FVC)和FEV_1/FVC也显著低于对照组(P <0. 05);对照组入选者营养状况良好,观察组65例患者中,营养良好者35例(53. 85%)、营养不良者30例(46. 15%),观察组中营养良好者MNA总分显著高于营养不良者(P <0. 05);观察组患者GSH、SOD、TAC显著低于对照组,MDA显著高于对照组(P <0. 05)。结论 COPD稳定期患者肺功能、营养状况及氧化应激能力三者关系密切,营养不良可能会导致氧化应激增强,进而造成肺功能水平下降,因此对患者采取干预营养状况的措施可取得良好的效果。
Objective To analyze the pulmonary function,nutritional status and oxidative stress ability of patients with chronic obstructive pulmonary disease(COPD) in stable stage. Methods A total of 65 COPD patients in our hospital were selected as experimental group,and another 35 healthy people as control group. The levels of adiponectin and pulmonary function were compared between the two groups. The nutritional assessment was performed by micronutrient assessment(MNA),and the levels of serum reduced glutathione(GSH),malondialdehyde(MDA),superoxide dismutase(SOD) and total antioxidant capacity(TAC) were measured. Results The level of adiponectin in the experimental group was significantly lower than that in the control group. The pulmonary function index such as ratio of forced expiratory volume in one second to predicted value(FEV_1%),forced vital capacity(FVC) and ratio of forced expiratory volume in one second to forced vital capacity(FEV_1/FVC) in the experimental group were also significantly lower than those in the control group(P < 0. 05). The nutritional status of all the participants in the control group was good.Among the 65 cases in the experimental group,35 cases(53. 85%) were well-nourished and 30 cases(46. 15%) were malnourished. The total MNA score of the well-nourished participants in the experimental group was significantly higher than that of those with malnutrition(P < 0. 05). The GSH,SOD and TAC of the experimental group were significantly lower,and MDA was higher than those of the control group(P < 0. 05). Conclusion The pulmonary function,nutritional status and oxidative stress ability of COPD patients in stable stage are closely related. Malnutrition may lead to increased oxidative stress,which may lead to a decline in pulmonary function. Therefore,interventions should be taken to improve the nutritional status of COPD patients.
Objective To analyze the pulmonary function,nutritional status and oxidative stress ability of patients with chronic obstructive pulmonary disease(COPD) in stable stage. Methods A total of 65 COPD patients in our hospital were selected as experimental group,and another 35 healthy people as control group. The levels of adiponectin and pulmonary function were compared between the two groups. The nutritional assessment was performed by micronutrient assessment(MNA),and the levels of serum reduced glutathione(GSH),malondialdehyde(MDA),superoxide dismutase(SOD) and total antioxidant capacity(TAC) were measured. Results The level of adiponectin in the experimental group was significantly lower than that in the control group. The pulmonary function index such as ratio of forced expiratory volume in one second to predicted value(FEV_1%),forced vital capacity(FVC) and ratio of forced expiratory volume in one second to forced vital capacity(FEV_1/FVC) in the experimental group were also significantly lower than those in the control group(P < 0. 05). The nutritional status of all the participants in the control group was good.Among the 65 cases in the experimental group,35 cases(53. 85%) were well-nourished and 30 cases(46. 15%) were malnourished. The total MNA score of the well-nourished participants in the experimental group was significantly higher than that of those with malnutrition(P < 0. 05). The GSH,SOD and TAC of the experimental group were significantly lower,and MDA was higher than those of the control group(P < 0. 05). Conclusion The pulmonary function,nutritional status and oxidative stress ability of COPD patients in stable stage are closely related. Malnutrition may lead to increased oxidative stress,which may lead to a decline in pulmonary function. Therefore,interventions should be taken to improve the nutritional status of COPD patients.
引文
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[13]张健,戈艳蕾,江振国,等.葡萄籽原花青素对慢性阻塞性肺疾病合并阻塞性睡眠呼吸暂停患者氧化应激和炎症反应的影响[J].临床内科杂志,2017,34(12):809-812.
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[15]吴丹,耿爽,赵苏,等.褪黑素对稳定期中重度慢性阻塞性肺疾病患者氧化应激和炎症反应的影响[J].实用医学杂志,2017,33(15):2431-2435.
[16]朱贵荣,韦建国.莫西沙星对COPD伴呼吸衰竭患者血清IL-10等炎症因子和氧代谢水平的影响[J].解放军预防医学杂志,2018,36(4):490-492,512.
[17]鲁平海,李晓作.COPD合并肺部感染患者接受盐酸氨溴索支气管肺泡灌洗后全身炎症及应激反应的评估[J].海南医学院学报,2017,23(21):2937-2940.
[18]张杰,叶慧芳,单艳华.硫化氢对脂多糖诱发的大鼠急性肺损伤肺组织中细胞凋亡及SOD、MDA水平的影响[J].实用预防医学,2018,25(6):753-756.
[19]闫芳,谢啟发,马炳原,等.氯胺酮预处理对卵蛋白激活的致敏大鼠肺泡巨噬细胞丙二醛及超氧化物歧化酶的影响[J].实用药物与临床,2017,20(9):987-989.
[20]白涛敏,张西嫔,卫丽.血清心肌肌钙蛋白、丙二醛及超氧化物歧化酶在病毒性心肌炎患儿临床诊治中的价值分析[J].中国临床医生杂志,2017,45(12):100-103.
[21]丁怡,陈旭如,陈家君,等.血清8-异前列腺F2α、丙二醛和过氧化氢酶在重叠综合征患者中的临床意义[J].河北医药,2017,39(18):2730-2733.
[2]徐传芹,何远强,陈建辉,等.营养不良对稳定期慢性阻塞性肺疾病患者认知功能的影响[J].实用临床医药杂志,2018,22(7):117-119,122.
[3]陈贝贝,李振华,胡红玲,等.慢性阻塞性肺病氧化应激状态和脂质水平研究[J].实用医学杂志,2017,33(13):2205-2208.
[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(2007年修订版)[J].中华结核和呼吸杂志,2007,46(1):8-17.
[5]刘欣艳,拓西平.营养支持对老年慢性阻塞性肺疾病急性加重期患者临床疗效和生活质量的影响[J].中国医药导报,2017,14(32):104-107,111.
[6]Co-Chair W J E,Miravitlles M,Hurst J R,et al.Management of COPD exacerbations:a European Respiratory Society/American Thoracic Society guideline[J].European Respiratory Journal,2017,49(3):791-806.
[7]尹海星,刘永,朱文艺,等.NRS 2002筛查COPD病人营养风险及与检查指标的相关性[J].肠外与肠内营养,2017,24(5):301-305.
[8]王强.玉屏风颗粒联合噻托溴铵治疗慢性阻塞性肺疾病营养不良患者的疗效分析[J].实用临床医药杂志,2018,22(19):72-74,78.
[9]朱珍,殷少军,魏丽,等.脂联素水平与慢性阻塞性肺疾病严重程度及CT特征的关系[J].中华老年多器官疾病杂志,2017,16(6):401-405.
[10]钟萍,蒋雪莲,黄成亮,等.激活素A与COPD稳定期患者营养状况及肺功能的关系[J].广东医学,2017,38(13):1985-1988.
[11]王露,刘虎,许建英,等.COPD急性加重期患者治疗前后血清4-HNE水平的变化[J].国际呼吸杂志,2017,37(7):494-498.
[12]武小杰,倪望.外周血活性氧作为标记物评估慢性阻塞性肺疾病中肺组织的氧化应激程度[J].内科急危重症杂志,2017,23(3):197-200.
[13]张健,戈艳蕾,江振国,等.葡萄籽原花青素对慢性阻塞性肺疾病合并阻塞性睡眠呼吸暂停患者氧化应激和炎症反应的影响[J].临床内科杂志,2017,34(12):809-812.
[14]王文俊.乙酰半胱氨酸对COPD稳定期患者氧化应激及细胞因子的影响[J].皖南医学院学报,2017,36(3):221-223.
[15]吴丹,耿爽,赵苏,等.褪黑素对稳定期中重度慢性阻塞性肺疾病患者氧化应激和炎症反应的影响[J].实用医学杂志,2017,33(15):2431-2435.
[16]朱贵荣,韦建国.莫西沙星对COPD伴呼吸衰竭患者血清IL-10等炎症因子和氧代谢水平的影响[J].解放军预防医学杂志,2018,36(4):490-492,512.
[17]鲁平海,李晓作.COPD合并肺部感染患者接受盐酸氨溴索支气管肺泡灌洗后全身炎症及应激反应的评估[J].海南医学院学报,2017,23(21):2937-2940.
[18]张杰,叶慧芳,单艳华.硫化氢对脂多糖诱发的大鼠急性肺损伤肺组织中细胞凋亡及SOD、MDA水平的影响[J].实用预防医学,2018,25(6):753-756.
[19]闫芳,谢啟发,马炳原,等.氯胺酮预处理对卵蛋白激活的致敏大鼠肺泡巨噬细胞丙二醛及超氧化物歧化酶的影响[J].实用药物与临床,2017,20(9):987-989.
[20]白涛敏,张西嫔,卫丽.血清心肌肌钙蛋白、丙二醛及超氧化物歧化酶在病毒性心肌炎患儿临床诊治中的价值分析[J].中国临床医生杂志,2017,45(12):100-103.
[21]丁怡,陈旭如,陈家君,等.血清8-异前列腺F2α、丙二醛和过氧化氢酶在重叠综合征患者中的临床意义[J].河北医药,2017,39(18):2730-2733.