无创机械通气对AECOPD患者骨骼肌泛素-蛋白酶体表达的影响  

The effect of noninvasive positive pressure ventilation on the expression of ubiquitin-proteasome of skeletal muscle in patients with AECOPD

作　　者：徐喜媛[1] 杨敬平[1] 田铁英 王慧[1] 乌日娜[1] 宋慧芳[1] 

机构地区：[1]内蒙古医科大学第三附属医院呼吸与危重症医学科、内蒙古呼吸与危重症医学研究所,包头014010

出　　处：《中国应用生理学杂志》2015年第5期414-417,共4页Chinese Journal of Applied Physiology

基　　金：内蒙古科技厅项目(2011MS1106)

摘　　要：目的:探讨无创机械通气(NIPPV)对慢性阻塞性肺病急性加重期(AECOPD)患者骨骼肌泛素-蛋白酶体的影响。方法:观察AECOPD患者13例,接受NIPPV为无创机械通气治疗组共7例,不接受NIPPV为无创机械通气对照组。监测治疗前及治疗后14 d血气分析、心率(HR)、平均动脉压(MBp),治疗后14 d进行肌肉活检,RTPCR方法观察骨骼肌核糖体蛋白S21(RPS21)、泛素、泛素结合酶E2(E2-14K)、泛素连接酶E3(E3-RBX1)mRNA表达,采用Western印迹法测定骨骼肌线粒体顺乌头酸酶(ACO2)、蛋白酶体C3(C3)、核糖体蛋白SLC16(SLC16)蛋白的表达。结果:治疗14 d后,NIPPV组与对照组相比:Pa CO2、Pa O2及HR明显改善(P<0.05);骨骼肌RPS21、泛素、E2及E3的mRNA表达明显减低(P<0.05,P<0.01),蛋白酶体C3、ACO2的蛋白表达显著增强(P<0.01),SLC16蛋白表达明显下调(P<0.01)。结论:NIPPV改善了AECOPD患者骨骼肌蛋白酶体途径及能量代谢紊乱。Objective： To investigate the effect of noninvasive positive pressure ventilation（NIPPV）on the gene and protein expression of biquitin-proteasome of skeletal muscle in patients with acute exacerbation of chronic obstructive puhnonary disease（AECOPD）. Methods： Sev- en patients with AECOPD by NIPPV were used as the study group, meanwhile, 6 patients with AECOPD who refused NIPPV was the control group. The blood gas analysis, heart rate （HR） and mean arterial pressure （MBp） were monitored before and 14 days after treatment. A skeletal muscle biopsy was performed after 14 days of therapy. The mRNA expression of ribosomal protein S21 （RPS21）, Ubiquitin, Ubiquitin combined with enzyme E2 （E2）, Ubiquitin ligase E3 （E3） in skeletal muscle cell were measured by RT-PCR. The protein expression of mito- chondrial aconitase （AC（h）, protease C3 （C3）, ribosomal protein SI/216 （SI/216） were detected by Western blot. Results： Forteen days af- ter treatment, the patients in NIPPV group got much better improvement in PaCO2, PaO2 and HR than that of the patients in the control group （ P 〈 0.05） .The gene expression of RPS21 ,Ubiquitin, E2 and E3 in skeletal muscle cell on patients with NIPPV were obviously lower than that of the control group （ P 〈 0.05, P 〈 0.01 ）. Compared with that of the control group, the protein expression of C3 and ACO2 increased signifi- cantly in the NIPPV group （ P 〈 0.01）. The protein expression of SLC16 was significantly lowered in the treated group （ P 〈 0.01）. Conclu- sion： NIPPV can ameliorate the proteasome pathway and energy metabolic disorders in patients with AECOPD.

关 键 词：无创机械通气 慢性阻塞性肺病 急性发作期 骨骼肌 泛素-蛋白酶体 

分 类 号：R56-2[医药卫生—呼吸系统]