摘要
目的通过测定COPD急性加重期（AECOPD）和COPD稳定期患者血清中4-羟基壬烯醛（4-HNE）、肿瘤坏死因子-α（TNF-α）和IL-6水平，探讨4-HNE在COPD严重程度评估中的作用。方法2010年1月至2011年6月在山西医科大学第一医院住院的AECOPD患者242例为AECOPD组，其中男182例，女60例，年龄54—89岁，平均（72±8）岁；门诊的COPD稳定期患者57例为COPD稳定期组，其中男55例，女性2例，年龄38～76岁，平均（60±8）岁；同期肺功能正常的健康体检者67例为对照组，其中男49例，女18例，年龄42—86岁，平均（66±10）岁。根据有无肺心病、呼吸衰竭及吸烟状态将AECOPD组分为不同亚组，根据肺功能及吸烟状态将COPD稳定期组分为不同亚组。采用酶联免疫吸附试验法测定各组血清中4-HNE、TNF—α和IL-6水平。两组间比较采用t检验或u检验，多组间比较采用方差分析或Kruskal-Wallis检验，采用Pearson等级相关分析和Spearman秩相关分析进行相关性检验。结果AECOPD组和COPD稳定期组患者血清中4-HNE水平[（16±4）mg／L和（15±5）mg／L]显著高于对照组[（12±4）mg／L]，控制年龄因素后，AECOPD组患者血清中4-HNE水平仍显著高于COPD稳定期组（F=7．93，P〈0．01）；AECOPD组吸烟、非吸烟和戒烟患者血清中4-HNE水平分别为（16±4）mg／L、（17±3）mg／L和（17±4）mg／L，差异无统计学意义（F值为1．23，均P〉0．05）；肺心病和无肺心病患者血清中4-HNE水平分别为（17±4）mg／L和（15±4）mg／L，差异有统计学意义（t=-4．37，P〈0．01）；COPD稳定期组吸烟和戒烟患者血清中4-HNE水平分别为（14±5）mg／L和（16±4）mg／L，差异无统计学意义（t=-1.44，P〉0．05）；COPD稳定期组血清中4-HNE水平与FEV1占预计值％呈负相关，与IL-6水平呈正相关（r值分别为-0．345和0．363，均P〈0．01）。结论不同吸烟状态的COPD患者外周血中4-HNE水平均有显著增高，尤其是AECOPD及合并肺心病的患者。COPD稳定期患者外周血中4-HNE与FEV，占预计值％呈负相关，与IL-6呈正相关，提示血清中4-HNE水平有可能成为评估COPD严重程度的生物标志物。
Objective To measure the levels of 4-hydroxynonenal （4-HNE）, TNF-ct and IL-6 in patients with acute exacerbation of chronic obstructive pulmonary disease （AECOPD） and stable COPD, and therefore to explore the role of 4-HNE in the assessment of COPD severity. Methods A total of 242 patients with AECOPD, 182 males and 60 females,age 54 -89 （mean 72 ± 8） years, 57 outpatients with stable COPD, 55 males and 2 females, age 38 - 76 （ mean 60 ± 8） years, and 67 healthy controls, 49 males and 18 females,age 42- 86 （mean 66±10） years, were included in the study. Based on whether there were respiratory failure, chronic pulmonary heart disease or a history of smoking, the patients with AECOPD were divided into different subgroups. Patients with stable COPD were divided into different subgroups based on lung function or whether there was a history of smoking. The serum 4-HNE, TNF-α and IL-6 concentrations were measured by using enzyme-linked immune sorbent assay （ELISA）. Results The serum 4-HNE levels in patients with AECOPD or stable COPD （ 16± 4） mg/L, （ 15 ± 5 ） mg/L were higher than those in healthy controls （12 ＋d） mg/L （both P 〈 0. 01 ）. After control for age, the serum 4-HNE levels in patients with AECOPD were significantly higher than those in stable COPD （ F = 7.93, P 〈 0. 01 ）. There were no differences in the serum 4-HNE among AECOPD patients of current smokers, non-smokers and ex-smokers （16±4） mg/L, （ 17 ± 3）mg/L, （ 17± 4） mg/L. The serum 4-HNE in AECOPD patients with chronic pulmonary heart disease were particularly higher （ 17±4） mg/L vs （ 15±4） mg/L （F = 1.23, P 〈0. 01 ）. There were no differences in the serum 4-HNE between stable COPD patients of current smokers and ex- smokers （ 14 ± 5） mg/L, （ 16± 4） mg/L （ t = - 1.44, P 〉 0. 05）. In patients with stable COPD, the serum 4-HNE levels were significantly correlated with FEV1% （ r = - 0. 345, P 〈 0. 01 ） and IL-6 （ r = 0. 363, P 〈 0. 01 ）. Conclusions The serum levels of 4-HNE in COPD patients with different smoking status were all significantly elevated, particular in patients with acute exacerbation and with pulmonary heart disease. In patients with stable COPD, the 4-HNE levels were negatively correlated with FEV1% and positively with serum IL-6 levels. It may be a valuable biomarkers for the assessment of COPD severity.
出处
《中华结核和呼吸杂志》
CAS
CSCD
北大核心
2012年第10期758-761,共4页
Chinese Journal of Tuberculosis and Respiratory Diseases
基金
国家自然科学基金（81141041）
关键词
肺疾病
慢性阻塞性
肺心病
氧化性应激
吸烟
4-羟基壬烯醛
Pulmonary disease, chronic obstructive
Pulmonary heart disease
Oxidative stress
Smoking
4-hydroxynonenal
