[1]杨培培,李 秀.血清25（OH）D水平对慢性阻塞性肺疾病急性加重的诊断价值[J].医学信息,2021,34(03):63-67.[doi:10.3969/j.issn.1006-1959.2021.03.019]
　YANG Pei-pei,LI Xiu.The Diagnostic Value of Serum 25（OH）D Level in Acute Exacerbation of Chronic Obstructive Pulmonary Disease[J].Medical Information,2021,34(03):63-67.[doi:10.3969/j.issn.1006-1959.2021.03.019]
点击复制

血清25（OH）D水平对慢性阻塞性肺疾病急性加重的诊断价值()
分享到：

医学信息[ISSN:1006-1959/CN:61-1278/R]

卷:
34卷
期数:
2021年03期
页码:
63-67
栏目:
论著
出版日期:
2021-02-01

文章信息/Info

Title:
The Diagnostic Value of Serum 25（OH）D Level in Acute Exacerbation of Chronic Obstructive Pulmonary Disease
文章编号:
1006-1959（2021）03-0063-05
作者:
杨培培; 李 秀
（安徽医科大学第三附属医院呼吸与危重症医学科，安徽 合肥 230061）
Author(s):
YANG Pei-pei; LI Xiu
(Department of Respiratory and Critical Care Medicine,the Third Affiliated Hospital of Anhui Medical University, Hefei 230061,Anhui,China)
关键词:
慢性阻塞性肺疾病急性加重; 25羟基维生素D; 降钙素原; C反应蛋白; 白介素-6; 肺功能
Keywords:
Acute exacerbation of chronic obstructive pulmonary disease; 25-hydroxy vitamin D; Procalcitonin; C-reactive protein; Interleukin-6; Lung function
分类号:
R563
DOI:
10.3969/j.issn.1006-1959.2021.03.019
文献标志码:
A
摘要:
目的 探讨慢性阻塞性肺疾病急性加重期（AECOPD）患者血清25羟基维生素D[25（OH）D]水平对AECOPD的诊断价值。方法 纳入2018年10月~2020年6月收治的AECOPD患者76例（AECOPD组），另选稳定期COPD患者70例（SCOPD组）和健康者54（CON组）为对照。比较三组血清25（OH）D、降钙素原（PCT）、C反应蛋白（CRP）、白介素-6（IL-6）及肺功能指标，分析血清25（OH）D与炎症因子及肺功能的相关性。ROC曲线分析血清25（OH）D单独及联合炎症因子对AECOPD的诊断效能。结果 AECOPD组和SCOPD组血清25（OH）D低于CON组（P＜0.05），而血清PCT、CRP、IL-6高于CON组（P＜0.05）；AECOPD组血清25（OH）D低于SCOPD组（P＜0.05），而血清PCT、CRP、IL-6高于SCOPD组（P＜0.05）；AECOPD组和SCOPD组第一秒用力呼气容积（FEV1）、FEV1占肺活量百分比（FEV1/FVC）、FEV1占预计值百分比（FEV1%预计值）低于CON组（P＜0.05），AECOPD组上述指标均低于SCOPD组（P＜0.05）；AECOPD组血清25（OH）D与PCT、CRP、IL-6、GOLD分级呈显著负相关（P＜0.05），与FEV1、FEV1/FVC、FEV1%预计值呈显著正相关（P＜0.05）；血清25（OH）D单独诊断AECOPD的AUC为0.776，联合PCT、CRP、IL-6及四者共同诊断AECOPD的AUC分别为0.848、0.827、0.816，0.887。结论 AECOPD患者血清25（OH）D水平明显降低，与炎症因子和肺功能具有显著相关性。血清25（OH）D可单独及联合炎症因子作为诊断AECOPD的潜在指标。
Abstract:
Objective To explore the diagnostic value of serum 25 hydroxy vitamin D [25（OH）D] level in patients with acute exacerbation of chronic obstructive pulmonary disease （AECOPD）.Methods A total of 76 AECOPD patients （AECOPD group） from October 2018 to June 2020 were enrolled, 70 patients with stable COPD （SCOPD group） and 54 healthy people （CON group） were selected as control group. The serum 25（OH）D, procalcitonin （PCT）, C-reactive- protein （CRP）, interleukin-6 （IL-6）, lung function indexes among the three groups were compared and the correlation between serum 25（OH） D and inflammatory factors and lung function was analyzed. ROC curve was applied to compare the diagnostic efficacy of serum 25（OH） D alone and combined with inflammatory factors for AECOPD.Results The serum 25（OH）D of the AECOPD group and the SCOPD group was lower than CON group （P＜0.05）, and the serum PCT, CRP and IL-6 were higher than CON group （P＜0.05）; The serum 25（OH）D of the AECOPD group was lower than SCOPD group （P＜0.05）,the serum PCT, CRP, IL-6 were higher than SCOPD group （P＜0.05）;The forced expiratory volume in the first second （FEV1）, the percentage of FEV1 in vital capacity （FEV1/FVC）, and the percentage of FEV1 in the predicted value （FEV1% predicted） in the AECOPD and SCOPD groups were lower than those in the CON group （P＜0.05）, the above indicators in the AECOPD group were lower than those in the SCOPD group （P＜0.05）; In AECOPD group, the serum 25（OH）D was significantly negatively correlated with PCT, CRP, IL-6, and GOLD grades （P＜0.05）, and significantly positively correlated with FEV1, FEV1/FVC, and FEV1% predicted value （P＜0.05）;The AUC of serum 25（OH）D alone for diagnosing AECOPD was 0.776, and the AUC of combined PCT, CRP, IL-6 and the four co-diagnosing AECOPD were respectively 0.848, 0.827, 0.816, 0.887.Conclusion The serum 25（OH）D level of AECOPD patients was significantly reduced, which was significantly correlated with inflammatory factors and lung function. Serum 25（OH）D can be used alone or in combination with inflammatory factors as a potential indicator for the diagnosis of AECOPD.

参考文献/References:

[1]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)[J].中国医学前沿杂志(电子版),2014,6(2):67-79,80. [2]慢性阻塞性肺疾病急性加重(AECOPD)诊治专家组.慢性阻塞性肺疾病急性加重(AECOPD)诊治中国专家共识(2017年更新版)[J].国际呼吸杂志,2017,37(14):1041-1057. [3]Janssens W,Bouillon R,Claes B,et al.Vitamin D deficiency is highly prevalent in COPD and correlates with variants in the vitamin D-binding gene[J].Thorax,2010,65(3):215-220. [4]Kokturk N,Baha A,Oh YM,et al.Vitamin D deficiency:What does it mean for chronic obstructive pulmonary disease(COPD)? a compherensive review for pulmonologists[J].Clin Respir J,2018,12(2):382-397. [5]Ferrari R,Caram LMO,Tanni SE,et al.The relationship between Vitamin D status and exacerbation in COPD patients-a literature review[J].Respir Med,2018(139):34-38. [6]Holick MF,Binkley NC,Bischoff-Ferrari HA,et al.Evaluation,treatment,and prevention of vitamin D deficiency:an Endocrine Society clinical practice guideline[J].J Clin Endocrinol Metab,2011,96(7):1911-1930. [7]Afzal S,Lange P,Bojesen SE,et al.Plasma 25-hydroxyvitamin D,lung function and risk of chronic obstructive pulmonary disease[J].Thorax,2014,69(1):24-31. [8]Wei Y,Wang S,Wang D,et al.Expression and clinical significance of serum amyloid A and interleukin-6 in patients with acute exacerbation of chronic obstructive pulmonary disease[J].Exp Ther Med,2020,19(3):2089-2094. [9]丁锋,张清会,徐慧,等.PCT与CRP和CD64指数对细菌感染慢性阻塞性肺疾病急性加重期患者诊断及指导治疗的意义[J].中华医院感染学杂志,2017(10):2198-2201. [10]Titova E,Christensen A,Henriksen AH,et al.Comparison of procalcitonin,C-reactive protein,white blood cell count and clinical status in diagnosing pneumonia in patients hospitalized with acute exacerbations of COPD:A prospective observational study[J].Chron Respir Dis,2019(16):1479972318769762. [11]Gao D,Chen X,Wu H,et al.The levels of serum pro-calcitonin and high-sensitivity C-reactive protein in the early diagnosis of chronic obstructive pulmonary disease during acute exacerbation [J].Exp Ther Med,2017,14(1):193-198. [12]Ganji V,Al-Obahi A,Yusuf S,et al.Serum vitamin D is associated with improved lung function markers but not with prevalence of asthma,emphysema,and chronic bronchitis[J].Sci Rep,2020,10(1):11542. [13]Sassi F,Tamone C,D’Amelio P.Vitamin D:Nutrient,Hormone,and Immunomodulator[J].Nutrients,2018,10(11):1656. [14]Heulens N,Korf H,Cielen N,et al.Vitamin D deficiency exacerbates COPD-like characteristics in the lungs of cigarette smoke-exposed mice[J].Respir Res,2015,16(1):110. [15]Burkes RM,Ceppe AS,Doerschuk CM,et al.Associations Among 25-Hydroxyvitamin D Levels,Lung Function, and Exacerbation Outcomes in COPD:An Analysis of the SPIROMICS Cohort [J].Chest,2020,157(4):856-865. [16]Schrumpf JA,Amatngalim GD,Veldkamp JB,et al.Proinflammatory Cytokines Impair Vitamin D-Induced Host Defense in Cultured Airway Epithelial Cells[J].Am J Respir Cell Mol Biol,2017,56(6):749-761. [17]Cielen N,Heulens N,Maes K,et al.Vitamin D deficiency impairs skeletal muscle function in a smoking mouse model[J].J Endocrinol,2016,229(2):97-108. [18]Ghosh AJ,Moll M,Hayden LP,et al.Vitamin D deficiency is associated with respiratory symptoms and airway wall thickening in smokers with and without COPD:a prospective cohort study[J].BMC Pulm Med,2020,20(1):123. [19]Khan DM,Ullah A,Randhawa FA,et al.Role of Vitamin D in reducing number of acute exacerbations in Chronic Obstructive Pulmonary Disease(COPD)patients[J].Pak J Med Sci,2017,33(3):610-614. [20]Jolliffe DA,Greenberg L,Hooper RL,et al.Vitamin D to prevent exacerbations of COPD:systematic review and meta-analysis of individual participant data from randomised controlled trials [J].Thorax,2019,74(4):337-345.

相似文献/References:

[1]王春远,刘成桂.成都市健康体检儿童25羟基维生素D水平分析[J].医学信息,2020,33(15):133.[doi:10.3969/j.issn.1006-1959.2020.15.041]
　WANG Chun-yuan,LIU Cheng-gui.Analysis on the Level of 25-hydroxy Vitamin D in Children UndergoingPhysical Examination in Chengdu[J].Medical Information,2020,33(03):133.[doi:10.3969/j.issn.1006-1959.2020.15.041]
[2]姜红峰,彭绍蓉,郭张强,等.低25(OH)D与老年2型糖尿病患者靶器官损害的关系[J].医学信息,2021,34(09):84.[doi:10.3969/j.issn.1006-1959.2021.09.022]
　JIANG Hong-feng,PENG Shao-rong,GUO Zhang-qiang,et al.The Relationship Between Low 25(OH)D and Target Organ Damage in Elderly Patients with Type 2 Diabetes[J].Medical Information,2021,34(03):84.[doi:10.3969/j.issn.1006-1959.2021.09.022]
[3]张东艳,张 森,刘 华.病毒感染相关慢性阻塞性肺病急性加重的免疫机制及潜在靶点研究进展[J].医学信息,2022,35(08):25.[doi:10.3969/j.issn.1006-1959.2022.08.007]
　ZHANG Dong-yan,ZHANG Sen,LIU Hua.Research Progress on Immune Mechanism and Potential Targets of Acute Exacerbation of Chronic Obstructive Pulmonary Disease Associated with Virus Infection[J].Medical Information,2022,35(03):25.[doi:10.3969/j.issn.1006-1959.2022.08.007]
[4]陈军平.不同用药途径的糖皮质激素对慢性阻塞性肺疾病急性加重患者气道微生态的影响[J].医学信息,2023,36(13):155.[doi:10.3969/j.issn.1006-1959.2023.13.034]
　CHEN Jun-ping.Effects on Glucocorticoids with Different Routes of Administration on Airway Microecology in Patients with Acute Exacerbation of Chronic Obstructive Pulmonary Disease[J].Medical Information,2023,36(03):155.[doi:10.3969/j.issn.1006-1959.2023.13.034]
[5]刘霖杰,袁晓梅.嗜酸性粒细胞在慢性阻塞性肺疾病中的研究现状[J].医学信息,2023,36(18):179.[doi:10.3969/j.issn.1006-1959.2023.18.037]
　LIU Lin-jie,YUAN Xiao-mei.Research Status of Eosinophils in Chronic Obstructive Pulmonary Disease[J].Medical Information,2023,36(03):179.[doi:10.3969/j.issn.1006-1959.2023.18.037]

更新日期/Last Update: 1900-01-01