慢性阻塞性肺疾病和阻塞性睡眠呼吸暂停低通气综合征患者外周血单个核细胞TNF—α、IL-8mRNA表达的研究  

Features and significance of mRNA expression of TNF-α and IL-8 between COPD and OSAHS patients

作　　者：陈飞鹏[1] 俞朝贤[2] 陈晓军[1] 潘巧红[1] 

机构地区：[1]广州医学院第二附属医院呼吸科,510260 [2]广州市胸科医院

出　　处：《中国临床实用医学》2009年第1期1-3,共3页China Clinical Practical Medicine

基　　金：广东省科技计划社会发展攻关项目（项目编号：2002C30407）;广东省医学科研课题立项项目（项目编号：A2002290）

摘　　要：目的分析慢性阻塞性肺疾病（COPD）、阻塞性睡眠呼吸暂停低通气综合征（OSAHS）及重叠综合征（overlap syndrome）患者单个核细胞TNF-α和IL-8mRNA表达的特点，从炎症反应方面探讨重叠综合征的发病机制。方法选取已确诊为COPD11例、OSAHS15例和重叠综合征4例各为一组，所有研究对象均行夜间多导睡眠图监测和肺功能检查，用半定量RT-PCR法检测外周血单个核细胞TNF-α、IL-8的mRNA水平。结果外周血单个核细胞在TNF-α的mRNA表达水平中，OSAHS组〈COPD组〈重叠组，差异均具有统计学意义（P均〈0．05）；在IL-8的mRNA表达水平中，COPD组和重叠组均高于OSAHS组，差异具有统计学意义（P均〈0．05），而COPD组和重叠组之间无显著性差异（P〉0．05）。COPD患者单个核细胞TNF—αmRNA表达水平与第一秒用力呼气容积（FEVI／Pre％）呈负相关（r=-0．894，P〈0．01），与低氧时间呈正相关（r=0．781，P〈0．01）；IL-8mRNA表达水平与FEVI／Pre％呈负相关（r=-0．859，P〈0．01），与低氧时间呈正相关（r=0．862，P〈0．01）。OSAHS患者单个核细胞TNF-αmRNA表达水平与呼吸暂停和低通气指数（AHI）、低氧时间均呈正相关（r=0．833、0．742，P均〈0．01）；IL-8mRNA表达水平与AHI、低氧时间均呈正相关（r=0．825、0．882，P均〈0．01）。结论COPD患者和重叠综合征患者的IL-8和TNF-α的mRNA表达高于OSAHS患者，且IL-8和TNF-α的mRNA表达与FEVI／Pre％、AHI和低氧时间均有较好的相关性，提示炎症反应也可能在重叠综合征的发病机制和发展中起着较为重要的作用。Objective To study the features and significance of mRNA expression of TNF-α and IL-8 in peripheral blood mononuelear cells（PBMCs） in patients with chronic obstructive pulmonary disease （COPD）, obstructive sleep apnea hypopnea syndrome （OSAHS）and COPD with OSAHS, which we called overlap syndrome. Methods PBMCs were isolated from 11 COPD patients,15 OSAHS patients and 4 overlap syndrome patients. The expression of TNF-α and IL-8 mRNA was assayed by RT-PCR. Results The expression of TNF-α mRNA was higher in Overlap Syndrome patients than that of COPD patients（P 〈0. 05）. There was no difference of the expression of IL-8 mRNA between COPD patients and Overlap Syndrome patients （P 〉 0. 05 ）. In the three groups, OSAHS is the lowest by the expression of neither IL-8 mRNA nor TNF-α （P 〈 0. 05）. The mRNA expressions of TNF -α were correlated negatively with FEVI/Pre% （r = 0. 894,P 〈 0. 01 ）, and were correlated positively with time of SaO2 〈90% （r = 0. 781 ,P 〈 0. 01 ）in COPD patients. The mRNA expressions of IL-8 were correlated negatively with FEVI/Pre% （ r = 4）. 859,P 〈 0. 01 ）, and were correlated positively with time of SaO2 〈 90% （r = 0. 862, P 〈 0. 01 ） in COPD patients, in OSAHS patients,the mRNA expressions of TNF -α and IL-8 were all correlated positively with AHI （r = 0. 833,0. 825 P 〈 0. 01 ）and time of SaO2 〈 90% （r = 0. 742,0. 882,P 〈 0. 01 ）. Conclusion Inflammation may play a pathogenic role in the development of COPD and overlap syndrome.

关 键 词：慢性阻塞性肺疾病 阻塞性睡眠呼吸暂停低通气综合征 重叠综合征 肿瘤坏死因子-α 白细胞介素-8 

分 类 号：R563[医药卫生—呼吸系统] R76[医药卫生—内科学]