慢性阻塞性肺疾病患者诱导痰和血浆中白三烯B_4的变化以及茶碱对其的影响  

Changes of leukotriene B_4 in induced sputum and plasma of patients with chronic obstructive pulmonary disease and the effects of theophylline

作　　者：丁艳苓[1] 姚婉贞[1] 刘政[2] 王玉柱[1] 

机构地区：[1]北京大学第三医院呼吸内科,100083 [2]中国石油天然气集团公司中心医院呼吸科

出　　处：《中华结核和呼吸杂志》2005年第7期441-444,共4页Chinese Journal of Tuberculosis and Respiratory Diseases

摘　　要：目的探讨白三烯B4(LTB4)在慢性阻塞性肺疾病(COPD)患者诱导痰和血浆的变化以及茶碱对其的影响。方法这个试验是前瞻性随机对照非盲法研究。40例COPD稳定期患者(C组),随机分为CA组(口服茶碱0·2g/次,每天2次,1个月)与CB组(不用任何茶碱类药物)。15名健康非吸烟者为正常对照组(H组)。评定各组基线水平以及C组随访1个月后的临床症状与生活质量评分,测定肺功能指标、诱导痰细胞计数与分类,并用酶联免疫吸附测定(ELISA)与酶免疫试验(EIA)方法分别测定诱导痰和血浆白细胞介素8(IL-8)与LTB4浓度。结果(1)C组诱导痰及血浆的LTB4水平分别为(794±305)pg/mg·pro、(5219±1185)ng/L,均显著高于H组[(155±64)pg/mg·pro、(2283±489)ng/L,P均<0·05]。(2)诱导痰的LTB4水平与中性粒细胞、IL-8水平呈显著正相关(r分别为0·453、0·364,P均<0·05)。(3)CA组在茶碱治疗前、后诱导痰LTB4水平分别为(812±592)、(657±459)pg/mg·pro,血浆水平为(5422±935)、(4589±1057)ng/L;CB组试验前、后诱导痰LTB4水平分别为(776±227)、(860±194)pg/mg·pro,血浆水平为(5074±1850)、(6063±2450)ng/L;这两组治疗前、后比较差异均无统计学意义(P均>0·05)。结论COPD患者LTB4水平增高,参与气道炎症过程。茶碱的治疗不能显著降低诱导痰与血浆的LTB4水平。Objective To investigate the changes of leukotriene B4(LTB4) in induced sputum and plasma of patients with chronic obstructive pulmonary disease(COPD) and the effects of theophylline. Methods The investigation was a prospective,randomized controlled trial. Forty stable COPD patients(group C) were randomized into a subgroup receiving oral theophylline 0.2 g twice a day for one month(group CA) and a subgroup receiving no theophylline(group CB). Fifteen age-matched healthy non-smokers(group H) were included as controls. The following measurements were performed at baseline for each group and one month later for group C:symptom and life quality scores,pulmonary function,cell counts and cell differentials in induced sputum,and concentrations of interleukin-8(IL-8) and LTB4 in both induced sputum and plasma by using enzyme linked immunosorbent assay(ELISA) and enzyme immunoassay(EIA). ResultsConcentrations of LTB4 in induced sputum[(794±305)pg/mg·pro] and plasma[(5 219±1 185)ng/L] in group C were significantly higher than those in group H[(347±169)pg/mg·pro,(2 283±489)ng/L,all P<0.05]. The level of LTB4 in induced sputum was positively correlated with the percentage of neutrophil(r=0.453,P=0.018) and IL-8(r=0.364,P=0.047). The pre- and post-therapy concentrations of LTB4 in induced sputum and plasma in group CA were (812±592),(657±459) pg/mg·pro and (5 422±935),(4 589±1 057)ng/L,respectively;while in group CB the concentrations were (776±227),(860±194) pg/mg·pro and (5 074±1 850),(6 063±2 450)ng/L,respectively. There were no significant changes either in the level of LTB4 in induced sputum or in plasma in both groups(all P>0.05). Conclusions The results suggest that LTB4 is involved in airway inflammation in COPD. Theophylline is not effective in decreasing the levels of LTB4 in both induced sputum and plasma of COPD patients.

关 键 词：慢性阻塞性肺疾病患者 诱导痰 白三烯B4 酶联免疫吸附测定(ELISA) 慢性阻塞性肺疾病(COPD) 白细胞介素8(IL-8) LTB4 生活质量评分 IL-8水平 COPD患者 血浆水平 茶碱类药物 正常对照组 肺功能指标 酶免疫试验 中性粒细胞 

分 类 号：R563.9[医药卫生—呼吸系统]