摘要
背景:慢性阻塞性肺疾病是以气道、肺实质和肺血管的慢性炎症为特征,这些炎症细胞数量增加和活性改变的机制目前还不十分清楚。目的:探讨慢性阻塞性肺疾病患者外周血中性粒细胞凋亡特点及其与慢性阻塞性肺疾病发生发展的关系,以期为慢性阻塞性肺疾病患者的早期干预和功能监测提供参考方向。设计:以慢性阻塞性肺疾病患者为观察对象,健康人群为对照组的观察对比研究。单位:一所军医大学医院的呼吸内科。对象:观察对象为2003-02/12因慢性阻塞性肺疾病急性发作在第三军医大学大坪医院野战外科研究所呼吸内科住院的慢性阻塞性肺疾病患者,同期同类住院患者98例,采用随机数字表法随机选择18例患者作为慢性阻塞性肺疾病组,其中男12例,女6例,年龄48～70岁,平均(56±7)岁。对照组14例,为来本院查体的健康成年人,其中男10例,女4例,年龄50～70岁,平均(59±8)岁。方法:用密度梯度离心法分离外周血中性粒细胞,利用流式细胞仪和原位末端标记技术观察外周血中中性粒细胞凋亡的动态变化。主要观察指标:各组外周血中性粒细胞凋亡率比较。结果:流式细胞分析显示,缓解期慢性阻塞性肺疾病患者凋亡早期中性粒细胞的比率为(8.5±1.3)%,明显低于正常对照组(12.5±1.8)%(t=6.25,P<0.01),急性加重期(5.1±0.6)
BACKGROUND:Chronic obstructive pulmonary disease(COPD) is characterized of chronic inflammation in airway,pulmonary parenchyma and pulmonary vessels.The mechanism of the increment and activity changes of these inflammatory cells is unclear at present. OBJECTIVE:To study the apoptotic character of peripheral blood polymorphonuclear neutrophils(PMNs) and its relationship with COPD to provide a reference for early intervention and function surveillance for COPD patients. DESIGN:An observatory comparative study based on COPD patients and healthy population as controls. SETTING:Department of pulmonary medicine in a military medical university of Chinese PLA affiliated hospital. PARTICIPANTS:Totally 98 COPD patients were admitted by the Department of Pulmonary Medicine,Research Institute of Surgery, Daping Hospital,Third Military Medical University of Chinese PLA between February 2003 and December 2003 due to COPD acute attack.Eighteen patients including 12 males and 6 females aged between 48 and 70 years old [mean of(56±7) years old]were randomly selected into COPD group according to random number table. Totally 14 healthy adults including 10 males and 4 females aged between 50 and 70 years old [mean of (59±8) years old] who were individuals came for physical check up in our hospital were selected in control group. METHODS:PMNs were separated from peripheral blood by density gradient centrifugation.The dynamic changes of PMNs apoptosis in peripheral blood was observed by flow cytometer and TUNEL method. MAIN OUTCOME MEASURES:Comparison of PMNs apoptotic rate in peripheral blood among groups RESULTS:As indicated by flow cytometric analysis,PMNs apoptotic rate at early apoptotic phase in COPD patients at paracmasis was(8.5±1.3)%,which was significantly lower than(12.5±1.8)%of normal control group(t =6.25,P< 0.01);PMNs apoptotic rate was(5.1±0.6)%at acute aggravation stage,which was significantly lower than that of paracmasis group(t=5.66, P< 001).As indicated by TUNEL analysis,PMNs apoptotic rate at paracmasis was(12.42±2.7)%, which was significantly lower than (21.5±4.8)%of normal control group(t=5.76,P< 0.01);PMNs apoptotic rate was(4.9±0.4)%at acute aggravation stage,which was significantly lower than that of paracmasis group(t=6.12,P< 0.01).PMNs changes at the late phase of apoptosis /necrosis had a contrary tendency,i.e.,PMNs rate at late apoptotic phase /necrosis was(2.8±0.5)%in COPD patients at paracmasis, which was significantly higher than(1.3±0.4)%of normal control group(t=6.37,P< 0.01); PMNs rate was (3.7±0.3)%at acute aggravation stage,which was significantly higher than that of paracmasis group(t=5.81,P< 0.01). CONCLUSION:PMNs abnormal apoptosis might be an important reason that induces PMNs aggregation in airway and lung tissues in COPD.This process might have an important significance in the generation and development of chronic airway inflammation, which provides an etiologic basis for the primary rehabilitative intervention of COPD.
出处
《中国临床康复》
CSCD
北大核心
2005年第15期215-217,共3页
Chinese Journal of Clinical Rehabilitation
