慢性阻塞性肺病患者血清 sFas 和 VEGF 浓度的相关性研 究简

目的 研究慢性阻塞性肺病（COPD）患者血清可溶性凋亡相关蛋白（sFas）和血管内皮生长因子（VEGF）浓度变化,探讨凋亡机制在COPD发病机制的作用,寻求评价COPD病情控制水平的凋亡/抗凋亡指标.方法 选择2011年8月～2013年8月就诊于广东药学院附属第一医院COPD急性发作期（急性期组）、治疗后达到稳定期（稳定期组）的患者139例,并选择33名正常对照者（正常对照组）,进行血清的sFas和VEGF浓度水平测定及肺功能的测定.结果 ①COPD急性期组（20.12±2.14）ng/mL]、稳定期组（17.90±2.07）ng/mL]、正常对照组（15.15±2.87）ng/mL]患者血清sFas浓度依次递减,差异均有统计学意义（P＜0.05）,而COPD稳定期组血清VEGF浓度（416.00±65.78） pg/mL]较急性期组（510.71±83.12）pg/mL]、正常对照组（521.60±35.75） pg/mL]下降,差异均有统计学意义（P＜0.05）,急性期组较正常对照组VEGF浓度下降,但差异无统计学意义（P＞0.05）.②COPD急性期组A、B、C、D各级患者血清sFas浓度分别为（18.48±1.32）、（19.02±1.56）、（20.96±1.82）、（21.91±1.84）ng/mL,呈增加趋势,B、C、D级间差异均有统计学意义（P＜0.05）.COPD急性期组A、B、C、D各级患者VEGF浓度分别为（587A±31.7）、（571.6±27.9）、（485.5±34.6）、（398.5±41.5）pg/mL,呈下降趋势,B、C、D级间差异均有统计学意义（P＜0.05）.③COPD稳定期各亚组患者血清sFas和VEGF浓度较急性期明显下降（P＜0.05）.④COPD急性期各亚组患者血清sFas和VEGF浓度与FEV1无相关性（P＞0.05）.结论 COPD患者体内存在细胞凋亡异常,血清sFas和VEGF浓度可以作为细胞凋亡的指标,衡量其病情变化及严重程度的指标.

Relevant research of serum sFas and VEGF levels in chronic obstructive pulmonary disease patients

Objective To study the effect of apoptosis mechanism in the pathogenesis of chronic obstructive pulmonary disease （COPD） by the measurement of serum Fas ligand （sFas） and VEGF levels, find the apoptosis markers which can be used to evaluate COPD disease control level. Methods 139 Cases with COPD in acute phase （acute phase group）, and stable phase after treatment （stable phase group） were selected in the First Affiliated Hospital of Guangdong Phar- maceutical University from August 2011 to August 2013, 33 normal controls were selected as control group. Then the concentration levels of serum sFas and VEGF and the function of pulmonary were determined. Results @The concen tration of sFas decreased progressively in acute phase group （20.12±2.14） ng/mL], stable phase group （17.90±2.07） ng/mL], and control group （15.15±2.87） ng/mL], the differences were statistically significant （P 〈 0.05）. The concentration of VEGF in stable phase group （416.00±65.78） pg/mL] was lower than the acute phase group （510.71±83.12） pg/mL] and the control group （521.60±35.75） pg/mL], the differences were statistically significant （P 〈 0.05）. The concentration of VEGF in acute phase grotip was lower than the control group, but the difference was not statistically significant （P 〉 0.05）. The sFas serum concentration of A, B, C, D degrees of acute exacerbation phase in COPD patients respective ly were （18.48±1.32）, （19.02±1.56）, （20.96±1.82）, （21.91±1.84） ng/mL, showed a trend of increase, the differences of B, C, D degrees were statistically significant （P 〈 0.05）. The VEGF serum concentration of A, B, C, D degrees of acute exacerbation phase in COPD patients respectively were （587.4±31.7）, （571.6 ±27.9）, （485.5±34.6）, （398.5±41.5） pg/mL, showed a trend of decrease, the differences of B, C, D degrees were statistically significant （P 〈 0.05）. @All the levels of serum sFas and VEGF concentrations in the stable phase group decreased compared with the acute phase group （P 〈 0.05）. @There was no correlation between concentration of sFas, VEGF and FEV 1 in acute exacerbation of COPD patients （P 〉 0.05）. Conclusion There is abnormal apoptosis in COPD patients, the concentration of sFas and VEGF can be used as the apoptosis indicators, which reflect the severity and activity condition of COPD.