维生素A对稳定期COPD患者细胞因子表达的影响

目的:探讨维生素A(VA)对稳定期慢性阻塞性肺疾病(COPD)患者细胞因子表达的影响。方法:将84例稳定期COPD患者随机均分为对照组、治疗1组及治疗2组,2个治疗组分别接受为期6个月的口服VA治疗,剂量分别为5000、10000u。采用高效液相色谱法测定患者血清中VA的浓度,放射免疫法测定治疗前、后患者诱导痰及血清细胞因子白细胞介素(IL)-8、IL-1β、肿瘤坏死因子(TNF-α)的水平,并记录不良反应。结果:治疗后3组患者血清VA浓度有所上升,具有时间和剂量依赖性,与治疗前比较差异有统计学意义(P<0.05)。补充VA1个月后,3组细胞因子水平较治疗前无明显增加,组间比较无统计学差异(P>0.05);3个月后,2个治疗组细胞因子水平较治疗前有所下降(P<0.05),但3组间比较无统计学差异(P>0.05);6个月后,2个治疗组细胞因子水平较3个月时进一步下降,3组比较差异有统计学意义(P<0.05),2个治疗组细胞因子水平均明显低于对照组(P<0.05),且治疗2组明显低于治疗1组(P<0.05)。结论:VA可以下调细胞因子IL-8、IL-1β、TNF-α的表达,进而抑制稳定期COPD患者的系统炎症反应。

Effect of Vitamin A on the Cytokines Expression of COPD Patients in Stable Stage

OBJECTIVE： To investigate the effect of vitamin A （VA） on cytokines expression of patients with chronic obstructive pulmonary disease （COPD） in stable stage. METHODS： 84 COPD patients in stable stage were randomly divided into 3 groups： first treatment group （VA 5 000 u）, second treatment group （VA 10 000 u） and control group. They were given oral dose of VA for 6 months. Adverse drug reactions were recorded. The serum concentration of VA was determined by HPLC. The levels of IL-8, IL-1β and TNF-α in serum and induced sputum were measured with RIA. RESULTS： The concentration of vitamin A was increased after treatment in time and dose dependent manners in 3 groups, there was statistical significance（P〈0.05）. After 1 month of treatment, cytokines levels had no significant change, there were statistical significance（P〈0.05）. The cytokines levels were lowered after 3 month（P〈0.05）. There was no statistical difference among 3 groups（P〈0.05）. After 6 months, the cytokines levels were significantly decreased in treatment groups, compared with after 3 months, there was statistical significance. The cytokines levels of treatment groups were lower than those of control group （P〈0.05）. Those of second treatment group were lower than those of first treatment group（P〈0.05）. CONCLUSION： VA could down-regulate the levels of IL-8, IL-1β and TNF-α and may restrain systemic inflammatory reaction of COPD patients in stable stage.