慢性阻塞性肺疾病患者呼出气冷凝液中白细胞三烯B4和肿瘤坏死因子-α的检测及其临床意义被引量：32

Determination and clinical implication of leukotriene B4 and tumor necrosis factor-α in condensate of exhaled breath of chronic obstructive pulmonary disease patients

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摘要目的观察慢性阻塞性肺疾病（COPD）患者呼出气冷凝液（EBC）中白细胞三烯B4（LTB4）和肿瘤坏死因子-α（TNF-α）浓度的改变及临床意义。方法收集20例COPD患者急性发作期和缓解期以及同期20例健康体检者（健康对照组）的EBC，检测EBC中LTB4和TNF-α；同时检测COPD患者的1秒用力呼气容积（FEV1）、最大呼气流量（PEF）、pH值、氧合指数（PaO2／FiO2）、动脉血氧分压（PaO2）及血白细胞（WBC）计数。结果COPD患者急性发作期和缓解期LTB4[（35．43±14．19）ng／L和（24．39±13．75）ng／L]均显著高于健康对照组[（16．75±7．44）ng／L]，而缓解期LTB4值显著低于急性发作期，差异均有统计学意义（P均〈0．05）。COPD患者急性发作期TNF-α[（9．35±8．66）ng／L]显著高于缓解期[（4．42±4．11）ng／L]和健康对照组[（4．45±3．92）ng／L]，差异均有统计学意义（P均〈0．05）；缓解期与健康对照组比较差异无统计学意义。COPD患者急性发作期LTB4浓度与FEV1／预计值呈显著负相关，回归方程y=0．51x＋0．22，r=-0．481，P〈0．05。结论COPD急性发作期LTB4和TNF-α水平的升高反映了氧化应激增强，其水平可作为反映COPD的病情严重程度和转归的指标。 Objective To study the changes and clinical implication of leukotriene B4 （LTB4） and tumor necrosis factor-α （TNF-α） in exhaled breath condensate （EBC） of chronic obstructive pulmonary disease （COPD） patients. Methods EBC of 20 patients in acute episode of COPD （AECOPD）, 20 patients in period of remission of COPD, and 20 persons who were having regular check-up （healthy control group） were enrolled. The concentrations of LTB4 and TNF-α in EBC were assayed. Forced expiratory volume in one second （FEV1） and peak expiratory flow （PEF） of COPD patients were observed at the same time, pH, oxygenation index （PaO2/FiO2）, partial pressure of oxygen in arterial blood （PaO2） and leukocyte count were also determined. Results （1）The concentrations of LTB4 in EBC of AECOPD （35.43±14.19）ng/L and remission of COPD（24.39±13.75） ng/L, were significantly higher than that of the healthy control group （16.75±7.44）ng/L, and the concentration of LTB4 in EBC during remission of COPD was significantly lower than that of AECOPD （all P〈0.05）. （2）The concentration of TNF-α in EBC of AECOPD （9.35±8.66） ng/L was significantly higher than that of remission of COPD （4.42±4.11） ng/L and healthy control group （4.45±3.92） ng/L, and the differences had statistical significance （both P〈 0.05）. The concentration of TNF-α in EBC showed no significant difference between patients in remission of COPD and healthy control group. （3）The concentration of LTB4 in EBC had negative correlation with FEV1 of AECOPD patients. Regression equation was y=- 0. 51x＋0. 22, r = - 0. 481 （P 〈 0.05 ）. Conclusion The concentrations of LTB4 and TNF-α in EBC of AECOPD patients are raised when oxidation stress is reinforced, and its level reflects the severity and prognosis of COPD.

作者陈金亮陈建荣陶一江蔡映云陶国华

机构地区南通大学第二附属医院呼吸科南通大学第二附属医院临床检验中心复旦大学附属中山医院呼吸病研究所

出处《中国危重病急救医学》 CAS CSCD 北大核心 2008年第6期357-360,共4页 Chinese Critical Care Medicine

基金江苏省南通市医药卫生科研基金资助项目（W0505）

关键词呼出气冷凝液肺疾病阻塞性慢性白细胞三烯B4 肿瘤坏死因子-Α exhaled breath condensate chronic obstructive pulmonary disease leukotriene B4 tumor necrosis factor-α

分类号 R563.9 [医药卫生—呼吸系统]

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