摘要
背景慢性阻塞性肺疾病(COPD)是一种严重危害人类健康的慢性病,氧化应激失衡是导致慢性阻塞性肺疾病急性加重(AECOPD)的主要原因之一,但其具体机制尚未完全阐明,而通过抑制氧化应激损伤的作用靶点来减少AECOPD的发病是目前研究的热点。目的探讨氧化应激失衡在AECOPD中的作用并分析其机制。方法选取2016年10月—2017年3月于西北民族大学第一附属医院暨宁夏回族自治区人民医院呼吸内科住院的AECOPD患者60例为病例组。选择同期于西北民族大学第一附属医院暨宁夏回族自治区人民医院体检的健康者60例为对照组。病例组患者经14 d雾化吸入和抗感染等对症治疗后好转出院,14 d后门诊随访病情明显缓解,咳嗽、咳痰、气促等症状稳定或症状轻微,未超出日常变异,为COPD稳定期。收集受试者一般资料,检测受试者氧化应激指标〔活性氧(ROS)、8-羟基脱氧鸟苷(8-OHdG)、蛋白质羰基(PC)、丙二醛(MDA)〕、抗氧化应激指标〔硫化氢(H2S)、总抗氧化能力(T-AOC)〕及血气分析指标〔动脉血氧分压(PaO2)、动脉血二氧化碳分压(PaCO2)〕、第1秒用力呼气容积占预计值百分比(FEV1%pred)、肺动脉收缩压(PASP)。根据《慢性阻塞性肺病全球倡议慢性阻塞性肺病指南(2013更新版)》中的分期标准,将AECOPD患者进一步分为Ⅱ级亚组(50%≤FEV1%pred<80%,25例)、Ⅲ级亚组(30%≤FEV1%pred<50%,21例)、Ⅳ级亚组(FEV1%pred<30%,14例)。根据《2015年欧洲心脏病学会(ESC)/欧洲呼吸学(ERS)肺动脉高压诊治指南》推荐的肺动脉高压(PH)诊断标准,以入院时PASP>50 mm Hg(6.67 kPa,1 mm Hg=0.133 kPa)为PH,将AECOPD患者进一步分为PH亚组(23例)、非PH亚组(37例)。结果病例组第1秒用力呼气容积占用力肺活量百分比(FEV1/FVC)低于对照组(P<0.05)。COPD患者急性加重期ROS、8-OHdG、PC、MDA、PaCO2、PASP高于对照组,H2S、T-AOC、PaO2、FEV1%pred低于对照组(P<0.05)。COPD�
Background Chronic obstructive pulmonary disease(COPD)is a chronic disease that seriously affects human health.The imbalance of oxidative stress is one of the main causes of acute exacerbation of chronic obstructive pulmonary disease(AECOPD).However,the specific mechanism has not been fully elucidated,and reducing the incidence of AECOPD by inhibiting the target of oxidative stress injury is a hot research topic.Objective To explore the effect of oxidative stress imbalance in AECOPD,and analyze its mechanism.Methods A total of 60 AECOPD patients hospitalized in the Department of Respiratory Medicine,the First Affiliated Hospital of Northwest University for Nationalities and People's Hospital of Ningxia Hui Autonomous Region from October 2016 to March 2017 were selected as the case group.Sixty healthy subjects who had received physical examination in the same hospital were selected as the control group.Patients in the case group were discharged after 14 days of symptomatic treatment such as atomization inhalation and anti-infection.After 14 days of outpatient follow-up,the condition was significantly relieved.Symptoms such as cough,sputum and shortness of breath were stable or mild,which did not exceed the daily variation,patients at this stage are considered to be in the COPD stable period.The general information of the subjects were collected,the oxidative stress indicators(ROS,8-OHdG,PC,MDA),antioxidant stress indicators(H2S,T-AOC)and blood gas analysis indexes(PaO2,PaCO2),FEV1%pred and PASP of the subjects were detected.According to the staging criteria ofG lobal Initiative for Chronic Obstructive Pulmonary Disease Guidelines for Chronic Obstructive Pulmonary Disease(2013 Update),AECOPD patients were further divided into gradeⅡsubgroup(50%≤FEV1%pred<80%,25 cases),gradeⅢsubgroup(30%≤FEV1%pred<50%,21 cases),gradeⅣsubgroup(FEV1%pred<30%,14 cases).According to the PH Diagnostic Criteria Recommended in 2015 ESC/ERS Guidelines for the Diagnosis and Treatment of Pulmonary Hypertension,patients with AECOPD w
作者
王曦
苑群
黄莎
邱国辉
耑冰
杨朝
WANG Xi;YUAN Qun;HUANG Sha;QIU Guohui;ZHUAN Bing;YANG Zhao(Department of Respiratory Medicine,the Affiliated Suzhou Science&Technology Town Hospital of Nanjing Medical University,Suzhou 215153,China;Department of Geriatrics Medicine,Zigong Mental Health Center,Zigong 643020,China;Department of Lung Disease,Weifang Traditional Chinese Hospital,Weifang 261000,China;Department of Respiratory Medicine,the First Affiliated Hospital of Northwest University for Nationalities and People's Hospital of Ningxia Hui Autonomous Region,Yinchuan 750011,China)
出处
《实用心脑肺血管病杂志》
2020年第12期64-70,共7页
Practical Journal of Cardiac Cerebral Pneumal and Vascular Disease
基金
国家自然科学基金资助项目(81560014)
2018宁夏回族自治区重点研发计划一般项目(2018BEG03052)
2019年度苏州市临床重点病种诊疗技术专项项目(LCZX201931)
2019年度苏州高新区医疗卫生科技计划项目(2019Z002)
2019年度苏州科技城医院中青年骨干预研基金项目(2019Y07)。
关键词
肺疾病
慢性阻塞性
急性加重期
氧化性应激
Pulmonary disease,chronic obstructive
Acute exacerbation
Oxidative stress
