摘要
目的探讨凋亡相关因子(Fas/Apo-1)和肿瘤坏死因子-α(TNF-α)介导的细胞凋亡及白介素-19(IL-19)、白介素-10(IL-10)在高原慢性阻塞性肺疾病(COPD)合并慢性肺心病(CCP)发病机制中的作用。方法采用双抗体夹心ABC-ELISA法测定60例高原COPD合并CCP急性加重期患者(急性加重组)和稳定期57例患者(稳定组)血清Fas/Apo-1、TNF-α、IL-19、IL-10浓度;测定1 s用力呼气容积(FEV1%)占预计值百分比(FEV1%pred)、动脉血氧分压(PaO2)和动脉血二氧化碳分压(PaCO2),并与30例当地健康人(健康组)进行比较。结果急性加重组和稳定组患者血清Fas/Apo-1、TNF-α、IL-19浓度和PaCO2[分别为(46.89±6.18)pg/ml、(18.37±3.26)ng/ml、(285.52±38.71)pg/ml、(56.36±5.28)mmHg和(37.25±4.82)pg/ml、(13.34±2.5)ng/ml、(166.12±32.45)pg/ml、(43.05±4.43)mmHg]显著高于健康组[分别为(30.44±4.16)pg/ml、(9.26±2.01)ng/ml、(86.59±20.91)pg/ml],血清IL-10浓度、FEV1%pred、PaO2[分别为(37.29±6.88)pg/ml、(33.19±5.45)、(35.22±5.26)mmHg和(55.36±7.62)pg/ml、(51.33±5.27)、(47.63±5.50)mmHg]显著低于健康组[(30.67±2.91)mmHg、(65.68±7.06)pg/ml、(72.15±5.23)、(68.08±529)mmHg](均P<0.01),急性加重组与稳定组比较亦有非常显著性差异(均P<0.01)。急性加重组血清Fas/Apo-1、TNF-α、IL-19与FEV1%pred、PaO2显著负相关(分别r=-0.525、-0.498、-0.603和-0.536、-0.528、-0.463,均P<0.01),与PaCO2显著正相关(分别r=0.533、0.562、0.498,均P<0.01);IL-10与FEV1%pred、PaO2显著正相关(分别r=0.476、0.563,均P<0.01),与PaCO2显著负相关(r=-0.525,P<0.01)。结论高原COPD合并CCP患者Fas/Apo-1和TNF-α表达上调介导细胞凋亡异常,Fas/Apo-1、TNF-α、IL-19和IL-10可能共同参与了气道慢性炎症反应。
Objective To investigate the factor associated suicide （Fas/Apo-1） and tumor necrosis factor-α （ TNF-α ） mediated apoptosis and interleukin-19 （ IL-19 ）, interleukin-10 （ IL-10） associated with pathogenesis of chronic obstructive pulmonary disease （COPD） complicated chronic cor pulmonale （CCP） at high altitude area. Methods The levels of serum Fas/Apo-1, TNF-α, IL-19, IL-10 were measured by double antibody sandwich ABC-ELISA method, FEV1% pred was measured by lung function instrument, and PaO2 and PaCO2 were measured by blood gas analyzer in 60 patients with COPD of acute exacerbationm （AECOPD） complicated CCP （AE group）, 57 patients with stable COPD complicated CCP（stable group）, and 30 healthy volunteers （control group） at high altitude area. Results Levels of serum Fas/Apo-1, TNF-α, IL-19 and PaCO2 in patients with AE and stable group [ （46.89 ± 6. 18 ） pg/ml, （ 18.37± 3.26） ng/ml, （285.52 ± 38.71 ）pg/ml and （56.36 ± 5.28 ）mmHg） and （37.25 ± 4.82 ）pg/ml, （ 13.34 ± 2.5 ） ng/ml, （ 166.12 ± 32. 45） pg/ml, （43.05 ±4.43）mmHg, respectively] were both markedly higher, and levels of serum IL-10, FEV1% pred and PaO2 [ （ 37.29 ± 6.88 ） pg/ml, （ 33.19 ± 5.45 ）, （ 35.22 ± 5.26） mmHg and （55.36 ± 7.62） pg/ml, （51.33 ± 5.27 ） , （47.63 ± 5.50）mmHg, respectively ] were both markedly lower than those of control group [ （ 30.44 ± 4.16） pg/ml, （ 9.26 ± 2.01 ） ng/ml, （ 86.59 ±20.91 ） pg/ml, （ 30.67 ± 2.91 ） mmHg, （ 65.68 ± 7.06） pg/ml, （72.15 ± 5.23 ）, （ 68.08 ± 529 ） mmHg, respectively ] （ all P 〈 0.01 ）, all parameters in AE group were different significantly compared with those in stable CCP group （ all P 〈 0. 01 ）. In AE group, levels of serum Fas/Apo-1, TNF-α, IL-19 were negatively correlated with FEV1% pred, PaO2 （r = -0. 525, - 0. 498, - 0. 603 and - 0. 536, - 0. 528, - 0. 463, respectively, all P 〈 0. 01 ）, were positively correlated with PaCO2 （ r = 0. 533,0. 562, 0. 498, respectively, all P 〈 0. 01 ）. IL-10 was both positively correlated with FEV1 % pred, PaO2 （ r = 0. 476, 0. 563, respectively, all P 〈 0. 01 ） , was negatively correled with PaCO2 （ r = - 0.525, P 〈 0. 01 ）. Conclusions Fas/FsaL and TNF-α expression up-regulated can mediate cells apoptosis abnormally in patients with COPD complicated CCP at high altitude area. Fas/FasL, TNF-α, IL-19 and IL-10 may participate in airway inflammatory process together.
出处
《中华肺部疾病杂志（电子版）》
CAS
2014年第3期9-13,共5页
Chinese Journal of Lung Diseases(Electronic Edition)
关键词
肺疾病
慢性阻塞性
肺心病
凋亡相关因子
肿瘤坏死因子-Α
白介素-19
白介素-10
高原地区
Chronic obstructive pulmonary disease
Chronic cor pulmonale
Factor associated suicide
Tumor necrosis factor- α
Interleukin-19
Interleukin-10
High altitude area
