卡介菌多糖核酸对慢性阻塞性肺疾病患者体液免疫及外周血白细胞介素-8和肿瘤坏死因子-α的影响  

The Effect of Bacillus Calmette-guerin Polysaccharides Nucleic Acid on Humoral Immunity,Interleukin-8 and Tumor Necrosis Factor-a in Patients with Chronic Obstructive Pulmonary Disease

作　　者：徐琳[1] 张程[1] 叶贤伟[1] 刘维佳[1] 余红[1] 张湘燕[1] 

机构地区：[1]贵州省人民医院呼吸与危重症医学科,贵阳550002

出　　处：《华西医学》2015年第1期1-5,共5页West China Medical Journal

基　　金：贵州省发展和改革委员会高新技术产业发展专项(2006814)~~

摘　　要：目的探讨卡介菌多糖核酸对慢性阻塞性肺疾病(COPD)患者体液免疫及外周血白细胞介素-8(IL-8)、肿瘤坏死因子-α(TNF-α)的影响,为临床上评估该药治疗COPD的疗效提供理论依据。方法随机选择2012年3月-2013年2月在呼吸与危重症医学科住院的老年COPD急性加重期患者30例,同期门诊随诊的COPD稳定期患者60例,同期在体检中心体检健康人60例,健康人分为老年健康组(n=30)和非老年健康组(n=30),均为正常对照组。各组均测定IL-8、TNF-α、免疫球蛋白A(Ig A)、免疫球蛋白G(Ig G)、免疫球蛋白M(Ig M)含量。COPD稳定期患者再随机分成2组:A组30例,B组30例。COPD B组除常规治疗外加用卡介菌多糖核酸0.35 mg/d,肌肉注射,3次/周;COPD A组只接受稳定期常规治疗,两组患者均观察1个月,于治疗前后测定外周血IL-8、TNF-α、Ig A、Ig G、Ig M含量。结果老年健康组外周血IL-8、TNF-α与非老年健康组比较差异无统计学意义(P>0.05),但Ig A、Ig G、Ig M较非老年健康组降低(P<0.05)。COPD急性加重期组与稳定期组、老年健康组比较外周血Ig A、Ig G、Ig M下降(P<0.05),但IL-8、TNF-α升高(P>0.05)。COPD A组常规治疗前后外周血IL-8、TNF-α、Ig A、Ig G、Ig M均无明显变化,差异无统计学意义(P>0.05)。COPD B组使用卡介菌多糖核酸治疗后,外周血Ig A、Ig G、Ig M较治疗前及A组治疗前、后升高(P<0.05),而IL-8、TNF-α较治疗前及A组治疗前、后下降(P<0.05)。结论随着年龄的增长,健康人的体液免疫功能下降。老年COPD患者存在体液免疫功能异常,急性加重期更为显著。卡介菌多糖核酸可降低COPD稳定期患者外周血炎症因子含量,增强体液免疫功能。Objective To study the effect of b-αcillus c-αlmette-guerin（BCG） polys-αcch-αrides nucleic -αcid on humor-αl immunity, interleukin（IL）-8 -αnd tumor necrosis f-αctor（TNF）-αin p-αtients with chronic obstructive pulmon-αry dise-αse （COPD）, -αnd to provide theoretic-αl b-αsis for ev-αlu-αtion of its clinic-αl effectiveness. Methods Thirty hospit-αlized elderly p-αtients with AECOPD tre-αted from M-αrch 2012 to Febru-αry 2013 -αnd 60 p-αtients with st-αble COPD tre-αted -αt the s-αme time were r-αndomly selected -αs the study subjects. At the s-αme time, 60 he-αlthy people from our physic-αl ex-αmin-αtion center were -αlso enrolled -αnd divided into two groups： the elderly he-αlthy group （n=30） -αnd nonelderly he-αlthy group （n=30）. IL-8, TNF-α IgA, IgG -αnd IgM levels were determined. The st-αble COPD group w-αs r-αndomly divided into two groups： group A （n=30） -αnd group B （n=30）. Group A received only routine ther-αpy; group B received both routine ther-αpy -αnd intr-αmuscul-αr injection of BCG polys-αcch-αride nucleic -αcid （0.35 mg/d-αy, three times -α week）.IL-8, TNF-α IgA, IgG -αnd IgM levels in peripher-αl blood were investig-αted before tre-αtment -αnd one month l-αter. Results There were no st-αtistic-αlly signific-αnt differences in IL-8 -αnd TNF-ct levels in peripher-αl blood between elderly he-αlthy group -αnd nonelderly he-αlthy group （P〉0.05）, but the IgA, IgG -αnd IgM levels were lower in the nonelderly he-αlthy group th-αn in the elderly he-αlthy group （P〈0.05）. Comp-αred with the elderly he-αlthy grouping, IgG -αnd IgM levels were signific-αntly lower in AECOPD group -αnd st-αble COPD group （P〉0.05）, but IL-8 -αnd TNF-αlevels were signific-αntly higher （P〉0.05）. There were st-αtistic-αlly signific-αnt differences in TNF-ct, IgA, IgG -αnd IgM levels between group B before -αnd -αfter tre-αtment （P 〉 0.05）. Conclusions Hum-αn＇s humor-αl im

关 键 词：慢性阻塞性肺疾病 卡介菌多糖核酸 体液免疫 肿瘤坏死因子-Α 白细胞介素-8 

分 类 号：R563.9[医药卫生—呼吸系统]