稳定期慢性阻塞性肺疾病患者营养不良与甲状腺激素、肺功能及血清IL-6、IL-18的关系研究

目的:观察稳定期慢性阻塞性肺疾病(COPD)患者营养不良与甲状腺激素、肺功能及血清白细胞介素(IL)-6、IL-18的关系。方法:选择2019年1月~2020年12月我院收治的稳定期COPD患者76例作为研究对象。根据患者的微型营养评定(MNA)评分将其分为营养不良组(n=31)和非营养不良组(n=45),比较两组患者的人口学资料、疾病相关因素,甲状腺激素三碘甲状腺原氨酸(T3)、甲状腺激素(T4)、促甲状腺激素(TSH)]水平,肺功能第1秒用力呼气量占预测值百分比(FEV1%pred)、第1秒用力呼气量与用力肺活量比值(FEV1/FVC)],血清IL-6、IL-18水平。分析MNA评分与甲状腺激素水平、肺功能及血清IL-6、IL-18水平的相关性。分析患者发生营养不良的危险因素。结果:营养不良组年龄高于非营养不良组(P<0.05)。营养不良组T3、T4、TSH、FEV1%pred、FEV1/FVC显著低于非营养不良组,血清IL-6、IL-18水平显著高于非营养不良组(P<0.05)。稳定期COPD患者的MNA评分与T3、T4、TSH、FEV1%pred、FEV1/FVC呈正相关,与IL-6、IL-18呈负相关(P<0.05)。多因素Logistic回归分析显示,年龄>60岁、T3≤1.60 nmol/L、T4≤73.00 nmol/L、TSH≤1.50 nmol/L、FEV1%pred≤60.00%、FEV1/FVC≤0.54、IL-6≥8.00 pg/mL、IL-18≥47.00 pg/mL是稳定期COPD患者营养不良的危险因素(P<0.05)。结论:稳定期COPD患者营养不良受多种因素影响,临床应针对相关因素给予有效干预,降低此类患者营养不良风险。

Relationship Study between Malnutrition and Thyroid Hormone, Lung Function, Serum IL-6, IL-18 in Patients with Stable Chronic Obstructive Pulmonary Disease

Objective:To observe the relationship between malnutrition and thyroid hormone,lung function,serum interleukin(IL)-6 and IL-18 in patients with stable chronic obstructive pulmonary disease(COPD).Methods:76 stable COPD patients from January 2019 to December 2020 in our hospital were selected as research objects.According to the Micronutrient assessment(MNA)score,the patients were divided into malnutrition group(n=31)and non malnutrition group(n=45).The demographic data,disease-related factors,thyroid hormonestriiodothyronine(T3),thyroid hormone(T4),thyroid stimulating hormone(TSH)],Lung functionPercentage of predicted forced expiratory volume in 1 second(FEV1%pred),ratio of forced expiratory volume in 1 second to forced vital capacity(FEV1/FVC)],serum IL-6 and IL-18 levels were compared between the two groups.The correlation between MNA score and thyroid hormone level,lung function,serum IL-6,IL-18 level was analyzed.The risk factors of malnutrition were analyzed.Results:The age of the malnutrition group were higher than those of the non malnutrition group(P<0.05).The levels of T3,T4,TSH,FEV1%pred and FEV1/FVC in malnutrition group were significantly lower than those in non malnutrition group,and the levels of serum IL-6 and IL-18 were significantly higher than those in non malnutrition group(P<0.05).MNA score of stable COPD patients was positively correlated with T3,T4,TSH,FEV1%pred,FEV1/FVC,and negatively correlated with IL-6 and IL-18(P<0.05).Multivariate Logistic regression analysis showed that age>60 years,T3≤1.60 nmol/L,T4≤73.00 nmol/L,TSH≤1.50 nmol/L,FEV1%pred≤60.00%,FEV1/FVC≤0.54,IL-6≥8.00 pg/mL,IL-18≥47.00 pg/mL were risk factors for malnutrition in stable COPD patients(P<0.05).Conclusion:Malnutrition in stable COPD patients is affected by a variety of factors,and effective clinical intervention should be given according to relevant factors to reduce the risk of malnutrition in such patients.