慢性阻塞性肺疾病患者血清和诱导痰中α-防御素1-3水平的变化及意义

目的 测定COPD急性加重期(AECOPD)和稳定期患者血清和诱导痰中?-防御素1-3(HNP1-3)水平,以探讨HNP1-3在COPD发病机制中的作用.方法 2006年10月至2007年9月收集30例AECOPD患者(AECOPD组),21例COPD稳定期患者(COPD稳定期组)及22例健康受试者(健康对照组)的血清和诱导痰,分别进行痰细胞计数和分类,用ELISA法检测血清和诱导痰中HNP1-3和白细胞介素-8(IL-8)水平,并分析HNP1-3水平与中性粒细胞、IL-8、气流阻塞之间的相关性.应用SPSS 11.5软件进行统计学分析,多组数据间比较采用单因素方差分析或卡方检验,采用Pearson或Spearman相关分析进行相关性检验.结果 AECOPD组诱导痰HNP1-3的中位数(四分位间距)9 652(4 272～12 576)ng/L]明显高于健康对照组4 194(700～10 505)ng/L]和COPD稳定期组7 011(6 658～7 319)ng/L],AECOPD组、COPD稳定期组和健康对照组血清HNP1-3的中位数(四分位间距)分别为51(39～173)ng/L、135(113～241)ns/L和130(13?60)ng/L,3组比较差异无统计学意义(x2=5.75,P＞0.05).诱导痰中HNP1-3水平与IL-8、中性粒细胞数及比例呈正相关(r值为0.29～0.53,P均＜0.01),与FEV1占预计值％、FEV1/FVC和PaO2呈负相关(r值为-0.33～-0.44,P均＜0.01).结论 HNP1-3参与COPD的炎症过程.此过程与中性粒细胞和IL-8等炎性因子有关.痰中HNP1-3水平可以作为COPD严重程度的指标.

The expression and implications of human α-defensin 1-3 in serum and induced sputum in patients with chronic obstructive pulmonary disease

objective To measure the levels of human ?-defensin 1-3(HNP1-3)in the serum and induced sputum in patients with chronic obstructive pulmonary disease (COPD) and therefore to investigate the possible roles of HNP1-3 in COPD.Methods Thirty patients with acute exacerbation of COPD.21 patients with stable COPD.and 22 healthy subjects were recruited.The concentrations of HNP1-3 and interleukin-8 (IL-8) in serum and induced sputum were measured by enzyme-linked immunosorbent assay (ELISA).The correlations among HNP1-3,neutrophils,IL-8,and lung functions were investigated.The data were analyzed using a statistical software package (SPSS 11.5).Variables were compared with One-Way ANOVA or Chi-squaretest.The correlations between variables were analyzed using Pearson's correlation coefficient or Spearman correlation coefficient.Results The sputum HNP1-3 level was significandy higher in AECOPD patients 9 652(4 272-12 576)ng/L] than in healthy subjects 4 194(700-10 505)ns/L,x2=7.53,P＜0.01] and in stable COPD patients 7 011(6 658-7 319)ng/L,x2=10.24,P＜0.01].There was significant difference among the three groups (x2=7.31,P＜0.05).There was no significant difierence in the serum HNP1-3 level among the three groups:AECOPD group 51(39-173)ng/L],stable COPD group 135(113-241) ng/L],healthy subjects group 130(13-160)ng/L],x2=5.75,P＞0.05.The sputum HNP1-3 level was positively correlated with the number,percentage of sputum neutrophils,and sputum IL-8 level (r=0.29 to 0.53,respectively P＜0.01).The sputum HNP1-3 level was negatively correlated with FEV1/predicted values,FEV1/FVC,and PaO2,(r=-0.33 to -0.44.respectively P＜0.01).Conclusions HNP1-3 may be involved in the pathogenesis of airway inflammation in COPD.Sputum HNP1-3 may be a noninvasive marker of severity of COPD.