白细胞粘附分子在慢性阻塞性肺疾病及肺心病发病中作用的探讨

目的：探讨白细胞粘附分子在慢性阻塞性肺疾病（COPD），慢性肺原性心脏病（肺心病）发病机制中的作用，及抗白细胞粘附疗法在肺心病治疗中的疗效。方法：采用流式细胞术，用单克隆抗一量测定42例COPD患（稳定期），41例肺心病患（稳定期）周围血中白细胞粘附分子CD11a,CD11b,CD18,CD54的阳性表达率，并以24名健康人作正常对照，41例肺心病患分为2组，治疗组20例，服用火把花根片（1次3片，1日3次），对照组21例，测定20例服火把花根片后的肺心病患周围血中白细胞粘附分子CD11a,CD11b,CSD18,CD54，淋巴细胞表面CD11a的阳性表达率明显高于正常对照组（P＜0．05），肺心病患组血液中性粒细胞表达CD11a,CD11b,CD18,CD54，单核细胞表面CD11a,CD18,CD54，淋巴细胞表面CD18较正常对照组明显增强（P＜0．05）；服火把花根片后，肺心病治疗组中性粒细胞表达CD11a,CD11b,CD18,CD54，单核细胞表面CD11a,CD18,CD54,淋巴细胞表达CD18较服药前肺心病组有显下降（P＜0．05），余各型均无显差异。结论：COPD患通过单核细胞粘附分子CD11a/CD18,CD11b/CD18,CD54的表达上调，肺心病患通过中性粒细胞表面粘附分子CD11a/CD18,CD11b/CD18,CD54及单核细胞表达CD11/CD18,CD54的表达上调，使白细胞与内皮细胞粘附明显增强，参与各自疾病的病理发展过程，火把花根通过肺心病中性粒细胞表面粘附分子CD11a/CD18,CD11b/CD18,CD54及单核细胞表达CD11a/CD18,CD54的表达下调，使白细胞与内皮细胞的粘附下降，阻止肺心病的发展。

Study of the function of leukocyte adhesion molecules in chronic

Objective To study the function of leukocyte adhesion molecules in the pathogenesis of Chronic Obstructive Pulmonary Diseases(COPD) and cor pulmonale, and to evaluate the effect of anti-leukocyte-adhesion therapy for cor pulmonale Methods The positive expression rates of CD 11a ,CD 11b ,CD 18 ,CD 54 in peripheral blood were quantitatively analyzed by flow cytometry using monoclonal antibodies in 42 cases of COPD(stable stage),41 cases of cor pulmonale(stable stage),24 healthy controls as well as 20 cases of cor pulmonale who had taken huobahua Results The expression rates of CD 11a ,CD 11b ,CD 18 ,CD 54 in monocytes and CD 11a in lymphocytes from the COPD group were much higher than those in the control group( P <0 05) CD 11a ,CD 11b ,CD 18 ,CD 54 in neutrophils and CD 11a ,CD 18 ,CD 54 in monocytes, and CD 18 in lymphocytes in the cor pulmonale group were significantly stronger than those in the control group( P <0 05);whereas the positive expression of CDs was greatly reduced in the cor pulmonale patients who had taken huobahua( P <0 05) No differences were found in other groups Conclusions Upregulation of CD 11a /CD 18 ,CD 11b /CD 18 ,CD 54 in monocytes, CD 11a /CD 18 , CD 11b /CD 18 , CD 54 in neutrophils and CD 11a /CD 18 ,CD 54 in monocytes in cor pulmonale may promote adhesion of leukocytes with endothelial cells, which may play an important role in the pathogenic process Huobahua may prevent the development of cor pulmonale by downregulating the expression of CDs