慢性阻塞性肺疾病急性加重期患者血清中TNF-α与sTNF-R55水平变化的研究  

hange of serum TNF-α and sTNF-R55 levels in subjects with acute exacerbations of COPD

作　　者：吴健锋[1] 曾勉[2] 

机构地区：[1]中山大学附属第一医院外科重症监护病房,510220 [2]中山大学附属第一医院呼吸内科,510220

出　　处：《广州医药》2006年第6期10-12,共3页Guangzhou Medical Journal

基　　金：广东省自然科学基金资助项目(04009385);广东省卫生厅基金项目(A2004188)

摘　　要：目的探讨慢性阻塞性肺疾病(COPD)急性加重期患者体内有无炎症介质与抗炎介质的失衡。方法检测15例COPD急性加重期患者入院第一天和治疗第七天血清中的TNF-α和sTNF-R55的水平。结果COPD急性加重期患者入院第一天和第七天血清液中的TNF-α浓度分别为(667.5±55.6)、(198.8±42.2)pg/m l,后者较前者明显下降(P<0.01);COPD急性加重期患者入院第一天和第七天血清液中的sTNF-R55浓度分别为(3.15±0.18)、(4.22±0.26)ng/m l,后者较前者明显上升(P<0.01)。结论急性加重期的COPD患者有体内炎症介质和抗炎介质的失衡,血清中炎症介质(TNF-α)水平升高,抗炎介质(sTNF-R55)水平降低,治疗后抗炎介质水平上升,炎症介质水平降低,两者趋于平衡。Objective To test the hypothesis that the chronic inflammatory process present in acute exacerbation of COPD is due to a defective endogenous anti-inflammatory mechanism. Methods Levels of the anti-inflammatory mediator soluble tumor necrosis factor receptor p55 （ sTNF-R55 ） and inflammatory mediator TNF-α were analyzed in 48 patients with acute exacerbations of COPD. In addition, changes in these mediators were studied during the first 7 days in hospital with an exacerbation of the disease. Results The mean TNF-α levels in day 1 and day 7 were （66. 7±55.6）, （ 198. 8±42.2） pg/ml respectively. TNF-α levels in day 7 were markedly reduced compared with day 1 （P 〈0. 001 ） ; The mean sTNF-R55 levels in day 1 and day 7 were （33.15±0. 18）, （4.22±0. 26） ng/ml respectively, sTNF-R55 levels in day 7 were markedly increased compared with day 1 （ P 〈 0. 001 ）, sTNF-R55 level was correlated positively with FEV 1%, but TNF-α level was correlated negatively with FEV1% . Conclusion These data suggest an imbalance in local levels of pro-and anti-inflammatory mediators in patients with acute exacerbation of COPD. The increase in the anti-inflammatory mediator sTNF-R55 during treatment of exacerbations may contribute to the clinical improvement.

关 键 词：肺疾病 阻塞性肿瘤坏死因子 可溶性肿瘤坏死因子受体 

分 类 号：R563.9[医药卫生—呼吸系统]