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论著:慢性阻塞性肺疾病稳定期患者氧化/抗氧化失衡、炎性反应与肺功能相关性的研究
Relationship between Oxidation/Antioxidation Imbalance, Inflammation and Pulmonary Function in Patients with Chronic Obstructive Pulmonary Disease in Stable Phase
高风英 王星海 伏春明 陈国平 金文强 朱丽华 柳金嫚 吴晓燕
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作者单位:上海市建工医院呼吸科
中文关键字:慢性阻塞性肺病;稳定期;呼吸功能;氧化/抗氧化失衡;炎性反应
英文关键字:Chronic obstructive pulmonary disease; Stable phase; Respiratory function; Oxidation/antioxidation imbalance; Inflammation
中文摘要:目的:通过检测稳定期不同级别慢性阻塞性肺疾病(COPD)患者血清中氧化/抗氧化指标细胞炎性因子水平及肺功能主要指标,了解血清氧化/抗氧化因子及细胞炎症因子水平的变化对肺功能的影响,探讨COPD稳定期肺组织慢性损伤的机制。方法:在呼吸科门诊筛查的COPD患者中选取80例, 按照2007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组。检测用力肺活量(FVC)、一秒钟用力呼气容积(FEV1)、FEV1/FVC; 用酶联免疫吸附试验(ELISA)方法测定患者血清中氧化指标反应性氧核素(ROS)、抗氧化指标超氧化物歧化酶(SOD)及细胞炎症因子肿瘤坏死因子-α(TNF-α)、白细胞介素-8(IL-8)、粒细胞-巨噬细胞集落刺激因子(GM-CSF)水平,比较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存在着显著负相关(P<0.05),然而SOD与其存在显著正相关(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COPD肺组织慢性损伤、肺功能降低的重要原因。
英文摘要:Objective: To explore the relationship between oxidation/antioxidation imblance, inflammation and pulmonary function in patients with chronic obstructive pulmonary disease(COPD) in stable phase, and to identify 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 enrolled and divided into GroupⅠ, GroupⅡ, Group Ⅲ and Group Ⅳ based on the diagnosis and treatment guidelines for COPD updated in 2007. The forced expiratory flow in first second (FEV1), forced vital capacity (FVC) and FEV1/FVC were recorded. for every patient. The levels of reactive oxygen species (ROS), superoxide dismutase (SOD)、tumor necrosis factor(TNF-a),interleukin-8(IL-8) and granulocyte macrophage colony stimulating factor (GM-CSF) were determined by enzyme-linked immunosorbent assay (ELISA). The relationship between these factors level and lung function were analyzed. Results: The levels of FEV1, FVC, FEV1/ FVC ,SOD, ROS, TNF-a, IL-8 and GM-CSF were significantly different in the four groups(P<0.05). The levels of ROS, TNF-a, IL-8, and GM-CSF were negatively correlated with that of the levels of FEV1 and FVC,but SOD were positively correlated with lung function. Conclusions: The continuous increase of the levels of cytokine and oxidative stress maybe play an important role in the exacerbation of pulmonary function in COPD patients of stable phase.
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