慢性阻塞性肺病患者氧化应激状态及其与糖皮质激素受体水平的相关性  

Oxidative stress status in patients with chronic obstructive pulmonary disease and its relation to glucocorticoid receptor levels

作　　者：刘凌云[1] 曾勉[1] 谢灿茂[1] 高景辉[2] 严英硕[1] 卢桂芳[1] 王辉[1] 贺云鹏[1] 

机构地区：[1]中山大学附属第一医院呼吸内科,广东广州510080 [2]中山大学附属第一医院同位素室,广东广州510080

出　　处：《南方医科大学学报》2008年第6期992-996,共5页Journal of Southern Medical University

基　　金：广东省自然科学基金(07001634);广东省卫生厅基金(A2004188)~~

摘　　要：目的观察不同时期慢性阻塞性肺疾病(COPD)患者全身及气道局部氧化应激水平的变化及其与糖皮质激素受体的相关性。方法检测33例COPD急性加重期患者(A组)、27例COPD稳定期患者(B组)、14例健康吸烟者(C组)、14例健康不吸烟者(D组)诱导痰及血浆中MDA、GSH水平和SOD、GSH-PX活性,及外周血有核细胞糖皮质激素受体(GR)水平、血皮质醇、ACTH水平。结果A、B、C、D组诱导痰和血浆MDA含量呈下降趋势,GSH、SOD、GSH-PX水平呈上升趋势,各组间差别有统计学意义(P<0.05);C组血浆和诱导痰的SOD水平低于D组(P<0.05),其他指标C、D组间差异统计学无意义(P>0.05)。A、B、C、D4组间血皮质醇及ACTH水平差别无意义(P>0.05),而GR水平依次呈上升趋势,分别为(1565±719)、(2069±488)、(2739±926)、(4793±1415)结合单位,各组间差别有统计学意义(P<0.05)。控制吸烟指数后,COPD患者外周血有核细胞GR水平与血浆及诱导痰SOD的相关系数分别为0.512、0.564,P<0.001,有统计学意义。结论COPD患者全身和气道局部均存在氧化/抗氧化失衡,尤以急性加重期患者更为明显;SOD活力下降可能是COPD患者糖皮质激素受体水平下降的原因之一。Objective To study changes in the levels of systematic and airway local oxidative stress in patients in different stages of chronic obstructive pulmonary diseases （COPD）, and explore the association between oxidative stress and glucocorticoid receptor （GR） level in the peripheral blood leukocytes. Methods The levels of malonaldehyde （MDA）, glutathione （GSH）, superoxide dismutase （SOD） and glutathione peroxidase （GSH-PX） in induced sputum and plasma, as well as GR levels in peripheral blood leukocytes and plasma levels of cortisol and adrenocorticotrophic hormone （ACTH）, were examined in 33 patients with acute exacerbations of COPD （AECOPD, group A）, 27 with stable COPD （group B）, and 28 healthy volunteers （including 15 smokers as＇group C, and 15 nonsmokers as group D）. Resdts MDA level in induced sputum and plasma decreased, whereas the levels of GSH, SOD and GSH-PX increased significantly in the order of groups A, B, C, and D （P〈0. 05）. The activity of SOD in induced sputum and plasma were significantly lower in group C than in group D. No significant difference was noted in the other oxidative stress indices between groups C and D （P〉0.05）. The plasma levels of cortisol and ACTH showed no significant difference between the 4 groups, while the GR level in peripheral blood leukocytes increased significantly in the order of groups A, B, C and D （1565±719, 2069±488, 2739±926, and 4793 ± 1415 U, respectively, P〈0.05）. After controlling for the factor of smoking status, the plasma and sputum SOD activity were both positively correlated to GR, with the partial correlation coefficient of 0.512 and 0.564, respectively （P〈0.001）. Conclusion Patients in different stages of COPD, especially those with AECOPD, may sustain systematic and local oxidation and anti-oxidation imbalance. Decreased SOD activity may contribute to GR level decrement in peripheral blood leukocytes in these patients.

关 键 词：慢性阻塞性肺疾病 氧化应激 糖皮质激素受体 诱导痰 

分 类 号：R563.9[医药卫生—呼吸系统]