老年COPD相关肺动脉高压病人血管活性肠肽水平及其与高凝、低氧状态和血管内皮功能的相关性

doi:10.3969/j.issn.1003-9198.2023.09.011

摘要/Abstract

摘要： 目的探讨老年COPD相关肺动脉高压(PH)病人血管活性肠肽(VIP)水平及其与高凝、低氧状态和血管内皮功能的相关性。方法收集226例老年COPD病人的年龄、性别、FEV1/FVC、纤维蛋白原(FIB)、D-二聚体(D-D)和PaO₂等资料,根据心脏彩超测量的肺动脉收缩压(PASP)是否≥40 mmHg分为COPD伴PH组(76例)和单纯COPD组(COPD组,150例)。采用ELISA法检测2组病人的血清内皮素-1(ET-1)和VIP水平,采用比色法测定一氧化氮(NO)水平。结果 2组年龄、性别、吸烟情况、BMI、血糖、血压和血脂水平差异均无统计学意义(P>0.05)。COPD伴PH组FEV1/FVC低于COPD组(P<0.05)。协方差分析调整了FEV1/FVC后,COPD伴PH组病人的VIP、NO和PaO₂水平低于COPD组,FIB、D-D水平高于COPD组(P<0.05或P<0.01)。在COPD伴PH组病人中,VIP与PaO₂正相关(r=0.713,P<0.001),与D-D负相关(r=-0.670,P<0.001)。结论老年COPD相关PH病人的VIP水平较低,且与高凝、低氧状态及血管内皮功能有密切联系。

关键词: 慢性阻塞性肺疾病, 肺动脉高压, 血管活性肠肽, 高凝状态, 低氧状态, 血管内皮功能

Abstract: Objective To investigate the serum level and association of vasoactive intestinal peptide (VIP) with hypercoagulability, hypoxemia and vascular endothelial function in the elderly patients with chronic obstructive pulmonary disease (COPD) complicated with pulmonary hypertension (PH). Methods The clinical data of age, gender, forced expiratory volume in one second/percentage of forced vital capacity (FEV1/FVC), fibrinogen (FIB), D-dimer (D-D) and arterial partial perssure of oxygen (PaO₂) were collected from 226 elderly patients with COPD. According to the pulmonary artery systolic pressure (PASP) measured by cardiac color ultrasound, the patients were divided into COPD with PH group (PASP≥40 mmHg, n=76) and COPD group (PASP<40 mmHg, n=150). The levels of serum endothelin-1 (ET-1) and VIP were detected by enzyme-linked immunosorbent assay (ELISA), and the level of serum nitric oxide (NO) was measured by colorimetry. Results There were no significant differences in age, gender, smoking history, the levels of body mass index (BMI), blood glucose, blood pressure and blood lipid between the two groups (P>0.05). FEV1/FVC in COPD with PH group was lower than that in COPD group (P<0.05). After adjusting FEV1/FVC by covariance analysis, the levels of VIP, NO and PaO₂ in COPD with PH group were lower than those in COPD group, and the levels of FIB and D-D were higher than those in COPD group (P<0.05 or P<0.01). Among the patients with PH, VIP was positively correlated with PaO₂(r=0.713, P<0.001), and negatively correlated with D-D (r=-0.670, P<0.001). Conclusions The level of VIP in the elderly patients with COPD-PH is closely related to hypercoagulability, hypoxemia and vascular endothelial function.

Key words: chronic obstructive pulmonary disease, pulmonary hypertension, vasoactive intestinal peptide, hypercoagulable state, hypoxemia, vascular endothelial function

中图分类号:

R 563.9

王世福, 欧宗兴, 符沙沙. 老年COPD相关肺动脉高压病人血管活性肠肽水平及其与高凝、低氧状态和血管内皮功能的相关性[J]. 实用老年医学, 2023, 37(9): 907-910.

WANG Shi-fu, OU Zong-xing, FU Sha-sha. Association of vasoactive intestinal peptides with hypercoagulability, hypoxemia and vascular endothelial function in elderly patients with chronic obstructive pulmonary disease complicated with pulmonary hypertension[J]. Practical Geriatrics, 2023, 37(9): 907-910.

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