老年稳定型慢性阻塞性肺疾病患者维生素D结合蛋白基因多态性的研究

Huanhuan Jiang, Chenci Jin, Sunshun Yan, Qiong Chi, Jian-wei Zheng, Longxiang Jiang, Ningning Yu
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摘要

目的探讨老年稳定期慢性阻塞性肺疾病(COPD)患者维生素D治疗效果与维生素D结合蛋白基因多态性的相关性。方法选取2016年9月至2018年11月温州四所医院呼吸内科收治的老年稳定期COPD患者800例。由于随访中途退出,我们的前瞻性研究最终纳入了776例患者。根据GC基因型将患者分为GC1F-1S组(n=214)、GC1F-1S组(n=168)、GC1F-2组(n=160)、GC1S-1S组(n=132)、GC1F-2组(n=82)和GC2-2组(n=44),每组随机分为对照组(n=400)给予常规治疗,治疗组(n=400)在常规治疗的基础上服用维生素D 0.5 μg/ D,疗程为3个月。观察并比较不同GC亚基因型患者治疗前后肺功能及COPD评估试验(CAT)评分。结果入选的老年患者中,以GC1F-1F基因型最常见,占26.8%(214例),其次为GC 1F-1S基因型,占21.0%(168例),GC2-2基因型最罕见,占5.5%(44例)。治疗后各组患者肺功能均较治疗前改善,CAT评分均降低(P < 0.05)。结论维生素D结合蛋白基因多态性与老年稳定期COPD患者补充维生素D的疗效相关,对补充维生素D的疗效具有预测价值。关键词:维生素D结合蛋白;多态性,单核苷酸;肺部疾病,慢性阻塞性
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Research on the vitamin D binding protein gene polymorphism in elderly patients with stable chronic obstructive pulmonary disease
Objective To discuss the correlation between the effect of vitamin D treatment and vitamin D binding protein gene polymorphism in elderly patients with stable chronic obstructive pulmonary disease(COPD). Methods A total of 800 elderly patients with stable COPD admitted to the four Departments of Respiratory Medicine of four Wenzhou Hospitals were enrolled from September 2016 to November 2018.Because of the drop-out during follow-up, there were final 776 patients in our prospective research.According to the GC gene type, patients were divided into the GC1F-1S(n=214), the GC1F-1S(n=168), GC1F-2(n=160), GC1S-1S(n=132), GC1F-2(n=82)and GC2-2 groups(n=44), and each group was randomly divided into control group(n=400)receiving the conventional treatment and the treatment group(n=400)taking vitmain D 0.5 μg/d for 3 months as add-on to the conventional treatment.The lung function and the COPD assessment test(CAT)score before and after the therapy were observed and compared in patients with different GC sub-genotypes. Results Among the elderly patients enrolled in our research, GC1F-1F genotype was most common, accounting for 26.8%(214 cases), the followings of next order were GC 1F-1S genotype accounting for 21.0%(168 cases), and GC2-2 genotype was most rare, accounting for 5.5%(44 cases). The lung function were improved and the CAT score were reduced in all groups after therapy as compared with pre-treatment(P 0.05). Conclusions Vitamin D binding protein gene polymorphism is associated with the curative effect of supplement of vitamin D in elderly patients with stable COPD, which has a predictive value for the curative effect of vitamin D supplement. Key words: Vitamin D binding protein; Polymorphism, Single nucleotide; Pulmonary disease, chronic obstructive
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