诱导痰技术在慢性阻塞性肺疾病患者氧化应激机制研究中的应用

目的利用谤导痰技术研究慢性阻塞性肺疾病(COPD)患者气道局部氧化应激水平的变化及其与COPD患者肺功能下降的关系。方法对40例急性加重期COPD患者(A组)、30例稳定期COPD患者(B组)、15例健康吸烟者(C组)进行痰诱导,并测定其诱导痰中脂质过氧化产物丙二醛(MDA)、非酶性抗氧化剂还原型谷胱甘肽(GSH)含量、酶性抗氧化剂超氧化物歧化酶(SOD)活性及谷胱甘肽过氧化物酶(GSH-PX)活性,并分析各指标与肺功能的关系。结果(1)COPD患者在痰诱导前和结束时及结束10min SpO_2、FEV_1均值比较变化无统计学意义(P>0.05);(2)A、B、C组间诱导痰MDA含量呈下降趋势,诱导痰GSH含量、SOD、GSH-PX活性呈上升趋势;(3)FEV_1与痰MDA、GSH含量及痰SOD、GSH-PX的活性相关系数分别为-0.776、0.778、0.788、0.800,P<0.05。结论痰诱导技术在COPD患者氧化应激机制研究中的应用具有一定的安全性,COPD患者气道局部均存在氧化/抗氧化失衡,尤以急性加重期患者更为明显,COPD患者氧化应激增加是导致肺功能下降的原因之一。

Application of sputum induction in studying the mechanism of oxidative stress in patients with COPD

Objective Sputum induction was applied to investigating the change of oxidative stress in local airway of patients with chronic obstructive pulmonary disease (COPD) and its correlation with pulmonary hypofunction.Methods Forty COPD pa- tients in acute exacerbation phase (group A),30 COPD patients in stable phase (group B),and 15 healthy smokers (group C) were enrolled in this experiment. All subjects underwent sputum induction,and the oxidative stress indices [malonaldehyde (MDA),reduced glutathione hormone (GSH),superoxide dismutase (SOD) and glutathione peroxidase (GSH-PX)] in the in- duced sputum were measured.Then,the relationship between the levels of oxidative stress indices in induced sputum and lung function were analyzed.Results(1) The change of the mean of SpO_2 and FEV1 before at the start,end and 10 rain after sputum induction was not statistically significant in the COPD patients (P>0.05).(2) Following the order of group A,B and C,a down- trend was found in the content of MDA in induced sputum,while an ascending trend was found in GSH and SOD levels of and GSH-PX activity in induced sputum.(3)The correlation coefficient between FEV1 and the oxidative stress indices (SOD,MDA, GSH,and GSH-PX) in the induced sputum was -0.776,0.778,0.788 and 0.800 respectively (P<0.05).Conclusion The spu- tum induction technique is safe in the application of sputum induction in studying the mechanism of oxidative stress in patients with COPD.The imbalance of and antioxidation occurred in the local airway of patients with (COPD),more evident in acute exacerba- tion phase.Enhancement of oxidative stress is one of the causes for pulmonary hypofunction in patients with COPD.