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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(FEV_1)、FEV_1/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-(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:FEV_1、FVC、FEV_1/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FEV_1、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。
OBJECTIVE: To investigate the changes of serum levels of oxidative / anti-oxidative factors and inflammatory cytokines in sera of patients with chronic obstructive pulmonary disease (COPD) at different stages of stable serum levels of oxidative / anti-oxidative cytokines and the main indexes of lung function Lung function of COPD stable mechanism of chronic lung injury mechanism. Methods: Eighty patients with COPD selected from respiratory clinic were divided into four groups according to the 2007 Guidelines for Diagnosis and Treatment of Chronic Obstructive Pulmonary Diseases: Ⅰ, Ⅱ, Ⅲ and Ⅳ. FVC, FEV 1 and FEV 1 / FVC were measured by enzyme linked immunosorbent assay (ELISA). Serum levels of ROS, antioxidant index The levels of superoxide dismutase (SOD) and tumor necrosis factor-α (TNF-α), interleukin-8 (IL-8) and granulocyte-macrophage colony stimulating factor (GM- Differences in each group and analysis of their relevance. Results: The levels of FEV 1, FVC, FEV 1 / FVC, SOD, ROS, TNF-α, IL-8 and GM-CSF differed in different groups (P < There was a significant negative correlation between GM-CSF level and FEV_1, FVC (P <0.05), however, there was a significant positive correlation between SOD and GM-CSF (P <0.05). CONCLUSION: The persistent increase of inflammatory cytokines and the increase of oxidative stress in COPD cells may be the important reason for chronic lung injury and pulmonary function decline in stable COPD patients.