慢性阻塞性肺疾病患者同型半胱氨酸水平变化及意义探讨

目的 探讨慢性阻塞性肺疾病(COPD)患者不同病期血浆同型半胱氨酸、血浆谷胱甘肽(GSH)水平的变化,以了解同型半胱氨酸在COPD患者发生、发展过程中的作用及其临床意义.方法 2006年1月至2008年6月收集46例COPD急性发作期患者(COPD急性发作期组)、45例COPD缓解期患者(COPD缓解期组)及38例健康受试者(健康对照组).测定各组的多项指标:吸烟指数、体质量指数、血浆同型半胱氨酸、血浆GSH、肺功能和动脉血气.结果 ①COPD急性发作期组血浆同型半胱氨酸高于健康对照组和COPD缓解期组,(31.93±26.19) μmol/L vs (10.79±2.32) μmol/L,(21.98±9.13) μmol/L,三组比较差异有统计学意义(F=13.08,P＜0.01).②COPD缓解期组血浆GSH明显低于健康对照组和COPD急性发作期组,(71.72±76.36) mg/L vs (166.38±63.51) mg/L,(145.18±80.41) mg/L,三组比较差异有统计学意义(F=19.11,P＜0.01).③COPD患者不论急性发作期,还是缓解期,血浆同型半胱氨酸与GSH均呈明显负相关(COPD急性发作期:r=0.579,P＜0.01;COPD缓解期:r=-0.721,P＜0.01);COPD急性发作期血浆GSH与第一秒用力呼气容积/用力肺活量呈正相关(r=0.488,P＜0.05).结论 COPD患者存在高同型半胱氨酸血症,血浆同型半胱氨酸参与COPD的氧化应激.

Changes and clinical significance of blood plasma homocysteine in patients with chronic obstructive pulmonary disease

Objective To explore the role and clinical significance of blood plasma homoeysteine in the pathogenesis and progression of chronic obstructive pulmonary disease (COPD) by examining the level of blood plasma homocysteine and glutathione (GSH).Methods Forty-six patients with acute exacerbation of COPD (group Ⅰ),45 patients with stable COPD (group Ⅱ) and 38 health volunteers (control group) were collected.Smoking index,body mass index,blood plasma homocysteine,blood plasma GSH,pulmonary Ⅰ was higher than that in group Ⅱ and control group,(31.93±26.19) μmol/L vs (21.98±9.13) μmol/L,lower than that in group Ⅰ and control group,(71.72±76.36) mg/L vs (145.18±80.41) mg/L,(166.38±plasma homocysteine and GSH in group Ⅰ (r=-0.579,P＜0.01) and group Ⅱ (r=-0.721,P＜0.01).There was a positive correlation between the level of blood plasma GSH and the ratio of forced expiratory volume in the first second and forced vital capacity in group Ⅰ (r=0.488,P＜0.05).Conclusions Homocysteinemia is higher in all COPD patients.The level of blood plasma homocysteine might be related with oxidative stress.