摘要目的:探讨慢性阻塞性肺疾病急性加重期（AECOPD）患者血清脂联素与炎性标志物、营养状态及重度急性加重次数的关系。方法:选取2017年7月至2019年4月上海市宝山区吴淞中心医院AECOPD男性患者163例，根据血清脂联素水平将患者分为低脂联素组（血清脂联素≤ 102.38 μg/L，97例）和高脂联素组（血清脂联素>102.38 μg/L，66例），比较两组白细胞介素（IL）-6、IL-8、红细胞沉降率（ESR）、C反应蛋白（CRP）、血红蛋白、白蛋白、前白蛋白、体质量指数（BMI）及随访1年重度急性加重次数，分析脂联素与炎性标志物、营养状态及1年内重度急性加重次数的关系。结果:低脂联素组BMI、血红蛋白、前白蛋白和白蛋白明显高于高脂联素组[（23.20 ± 3.26）kg/m 2比（20.77 ± 3.78）kg/m 2、（133.23 ± 17.13）g/L比（125.68 ± 20.83）g/L、（185.36 ± 57.60）g/L比（148.83 ± 64.79）g/L、（37.09 ± 4.06）g/L比（33.77 ± 5.86）g/L]，差异有统计学意义（ P<0.01或 P<0.05）；两组总蛋白、IL-6、IL-8、CRP和ESR比较差异无统计学意义（ P>0.05）。脂联素与BMI、血红蛋白、白蛋白和前白蛋白呈负相关（ r = -0.42、-0.28、-0.33和-0.31， P<0.01），与IL-6、IL-8、ESR、CRP无相关性（ P>0.05）。低脂联素组随访1年重度急性加重≥ 4次率明显低于高脂联素组[8.25%（8/97）比22.73%（15/66）]，差异有统计学意义（ χ2 = 6.79， P<0.05）。 结论:低脂联素AECOPD患者营养状态好，重度急性加重次数少。血清脂联素可作为AECOPD患者重度急性加重的预测指标。

abstractsObjective:To investigate the correlation between serum adiponectin (APN) and inflammatory markers, nutritional status and severe acute exacerbation in late stage in patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD).Methods:One hundred and sixty-three male patients with AECOPD from July 2017 to April 2019 in Wusong Hospital of Baoshan District, Shanghai City were selected. The patients were divided into low APN group (serum APN ≤ 102.38 μg/L, 97 cases) and high APN group (serum APN>102.38 μg/L, 66 cases). The interleukin (IL)-6, IL-8, erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), hemoglobin, albumin, prealbumin, body mass index (BMI) and number of severe acute exacerbation in 1 year′ follow-up were compared between 2 groups, and the correlation between APN and inflammatory markers, nutritional status and number of severe acute exacerbation were analyzed.Results:The BMI, hemoglobin, prealbumin and albumin in low APN group were significantly higher than those in high APN group: (23.20 ± 3.26) kg/m 2 vs. (20.77 ± 3.78) kg/m 2, (133.23 ± 17.13) g/L vs. (125.68 ± 20.83) g/L, (185.36 ± 57.60) g/L vs. (148.83 ± 64.79) g/L, (37.09 ± 4.06) g/L vs. (33.77 ± 5.86) g/L, and there were statistical differences ( P<0.01 or<0.05); there were no statistical differences in total protein, IL-6, IL-8, CRP and ESR between 2 groups ( P>0.05). APN showed negative correlation with BMI, hemoglobin, albumin and prealbumin ( r = -0.42, -0.28, -0.33 and -0.31; P<0.01); there was no correlation with IL-6, IL-8, ESR and CRP ( P>0.05). The rate of 4 times of severe acute exacerbation in 1 year′ follow-up in low APN group was significantly lower than that in high APN group: 8.25% (8/97) vs. 22.73% (15/66), and there was statistical difference ( χ2 = 6.79, P<0.05). Conclusions:The AECOPD patients with low APN have better nutritional status and less exacerbation. Serum APN can be used as a predictive index of severe acute exacerbation in AECOPD patients