COPD不同HRCT表型患者血清中性粒细胞弹性蛋白酶、总抗氧化能力比较

  目的   探讨中性粒细胞弹性蛋白酶（neutrophil elastase，NE）、总抗氧化能力（total antioxidative capability，T-AOC）在慢性阻塞性肺疾病（chronic obstructive pulmonary disease，COPD）高分辨率CT（high-resolution computed tomography，HRCT）不同表型中的差异。   方法   对78例门诊COPD患者，采用HRCT将COPD患者分为A表型、M表型和E表型，分别测定三组患者NE及T-AOC。   结果   COPD患者M表型的血清NE含量高于对照组、A表型、E表型（P < 0.05）；E表型的血清NE含量高于对照组、A表型（ P < 0.05）；三组及对照组T-AOC差异无统计学意义（ P > 0.05）；血清NE与FEV1、FEV1%pred呈负相关（ P < 0.05），与CAT评分呈正相关（ P < 0.05）。   结论   NE在COPD患者不同HRCT表型中的表达上调并与肺功能指标相关，NE可能参与了COPD的气道炎症、气道重构过程，并引起气流阻塞。

Comparative Study of Neutrophil Elastase and Total Antioxidant Capacity in Serum of COPD Patients with Different HRCT Phenotypes

  Objective   To explore the neutrophil elastase（neutrophil elastase, NE）, total antioxidant capacity（total antioxidative capability, T - AOC）in chronic obstructive pulmonary disease（chronic obstructive pulmonary diseases, COPD）high-resolution CT（high-resolution computed tomography, HRCT）in different HRCT phenotypes.   Methods   HRCT was used for typing 78 patients with out-patient COPD into phenotype A, phenotype M and phenotype E; NE and T-AOC of the three groups of patients were tested.   Results   The serum NE concentration of phenotype M in COPD patients was higher than that of control group, phenotype A and phenotype E（P < 0.05）. The serum NE concentration of phenotype E was higher than that of control group and phenotype A（ P < 0.05）. There was no significant difference in T-AOC between the three groups and the control group（ P > 0.05）. The NE in serum was negatively correlated with FEV1 and FEV1% pred.（ P < 0.05）, and positively correlated with CAT score（ P < 0.05）.   Conclusion   The expression of NE in COPD patients with different HRCT phenotypes is up-regulated and correlated with lung function indicators, and NE may be involved in airway inflammation and airway remodeling in COPD and cause airflow obstruction.