目的 探讨血尿酸(Serum Uric Acid,SUA)、酸碱平衡紊乱及其交互作用对慢性阻塞性肺疾病(Chronic Obstructive Pulmonary Disease,COPD)患者免疫功能下降的影响.方法 选取2022年10月—2023年10月钦州市第二人民医院收治的223例COPD患者为研究对象.根据患者是否出现免疫功能下降分为免疫功能下降组(n=67)和免疫功能正常组(n=156).比较两组的SUA水平、血氧分压(Partial Pressure of Oxygen,PO2)、二氧化碳分压(Partial Pressure of Carbon Dioxide,PCO2)、碳酸氢根离子和碱剩余(Base Excess,BE),分析SUA和酸碱平衡指标之间的交互作用.结果 两组PO2、PCO2、碳酸氢根离子和SUA水平比较,差异有统计学意义(P均<0.05).PO2、PCO2、碳酸氢根离子、SUA均为COPD患者免疫功能下降的影响因素(OR=2.484、2.554、2.891、5.757,P均<0.05);碳酸氢根离子与SUA存在相加交互作用,但未发现存在相乘交互作用;PO2、PCO2 与SUA均不存在相加、相乘交互作用.结论 SUA、PO2、PCO2和碳酸氢根离子是COPD患者免疫功能下降的影响因素,并且SUA和HCO3存在相加交互作用,各因素之间无相乘交互作用.
Study on the Role of Blood Uric Acid,Acid-base Balance Disturbance and Their Interaction in the Decline of Immune Function in Chronic Obstruc-tive Pulmonary Disease
Objective To investigate the effects of serum uric acid(SUA),acid-base balance disturbance and their in-teraction on the decline of immune function in patients with chronic obstructive pulmonary disease(COPD).Methods 223 COPD patients who admitted to the Guangxi Qinzhou Second People's Hospital from October 2022 to October 2023 as were selected study objects.The patients were divided into the decreased immune function group(n=67)and the normal immune function group(n=167)according to whether they showed decreased immune function or not.SUA level,partial pressure of oxygen(PO2),partial pressure of carbon dioxide(PCO2),bicarbonate ion and base excess(BE)were compared between the two groups.The interaction between SUA and acid-base balance indicators was analyzed.Results The levels of PO2,PCO2,bicarbonate ion,and SUA between the two groups were compared,and the differ-ences were statistically significant(all P<0.05).PO2,PCO2,bicarbonate ion,and SUA were all influential factors in the decline of immune function in COPD patients(OR=2.484,2.554,2.891,5.757,all P<0.05).There was an additive in-teraction between bicarbonate ion and SUA,but no multiplicative interaction was found.There was no additive or mul-tiplicative interaction between PO2,PCO2 and SUA.Conclusion SUA,PO2,PCO2 and bicarbonate ion are influential factors in the decline of immune function in COPD patients,and there is an additive interaction between SUA and bi-carbonate ion,with no multiplicative interaction between the factors.