慢性阻塞性肺疾病稳定期慢性肺损伤的机制研究

目的通过检测稳定期不同级别慢性阻塞性肺疾病患者血清中氧化/抗氧化指标及细胞炎症因子水平与肺功能主要指标的关系,探讨血清氧化/抗氧化因子及细胞炎症因子水平的变化对肺功能的影响,从而明确COPD稳定期慢性肺损伤的机制。方法在呼吸科门诊筛查的COPD稳定期患者中选取80例,按照2011年《慢性阻塞性肺疾病诊治指南》标准分级,分成4组:Ⅰ级组、Ⅱ级组、Ⅲ级组、Ⅳ级组。检测用力肺活量(FVC)、1秒钟用力呼气容积(FEV1)、FEV1/FVC;用ELISA方法测定患者血清中氧化指标反应性氧核素(ROS)、氧化/抗氧化指标超氧化物歧化酶(SOD)及细胞炎症因子中的肿瘤坏死因子-α(TNF-α)、IL-8及粒-巨细胞集落刺激因子(GM-CSF)水平,观测各组的差异并分析其相关性。结果 FEV1、FVC、FEV1/FVC、SOD、ROS、TNF-α、IL-8、GM-CSF水平在不同组别中存在差异(P<0.05),且ROS、TNF-α、IL-8、GM-CSF水平与FEV1,FVC存在着明显的负相关(P<0.05),然而SOD与其存在明显正相关(P<0.05)。结论 COPD细胞炎症因子的持续升高及氧化加重可能是引起稳定期慢性阻塞性肺疾病肺组织慢性损伤、功能降低的重要原因。

The Investigation the Mechanism of Chronic Lung Scathing of Chronic Obstructive Pulmonary Disease in Stable Phase

Objective To explore the relationship of serum oxidation/antioxidation and cytokines level with pulmonary function of chronic obstructive pulmonary disease in stable phase,analysing the influence of serum oxidation/antioxidation and cytokines to the pulmonary function,identified the mechanism of chronic lung injury of chronic obstructive pulmonary disease in stable phase.Methods A total of 80 COPD patients in stable phase from the respiratory clinic,were divided intoⅠdegree,Ⅱdegree,Ⅲdegree and Ⅳdegree Group based on GOLD grading standard of 2011.To determined the FVC,FEV1,FEV1/FVC of every patient by pulmonary function analyser,and to investigate level of ROS,superoxide dismutase(SOD),tumor necrosis factor-alpha(TNF-α),interleukin-8(IL-8),granulocyte macrophage colony stimulating factor(GM-CSF) by ELISA,then to analyse the relationship between these factors level and lung function.Results The levels of FEV1,FVC,FEV1/FVC,SOD,ROS,TNF-α,IL-8 and GM-CSF are significantly different in various grades(P<0.05).The levels of ROS,TNF-α,IL-8 and GM-CSF were negatively correlated with that of FEV1 and FVC,but SOD were positively correlated with lung function.Conclusion The continuous increase of COPD cytokine and ROS maybe important causes resulting in the chronic lesions in pulmonary tissues and the lower pulmonary function in COPD patients of stable phase.