黄芪注射液对慢性阻塞性肺疾病患者黏附分子表达的影响

Effects of astragalus injection on adhesion molecule expression in patients with chronic obstructive pulmonary disease

目的:探讨黏附分子与慢性阻塞性肺疾病(COPD)的关系及黄芪注射液在抗白细胞黏附方面的作用。方法:5 8例COPD患者随机分为黄芪注射液治疗组(30例)和常规治疗组(2 8例) ,健康体检者2 0例作为正常对照组。采用流式细胞术和酶联免疫吸附法(EL ISA)测定COPD患者治疗前后及正常对照组中性粒细胞(PMN)黏附分子CD11b/ CD18表达及血清中细胞间黏附分子1(ICAM 1)水平。结果:COPD患者急性加重期和缓解期CD11b/ CD18表达(86 .1±9.8和76 .6±8.2 )和ICAM 1〔(2 19.2 1±15 .2 3)μg/ L和(188.94±13.2 7)μg/ L〕均明显高于正常对照组〔5 3.3±7.6和(132 .37±16 .5 9)μg/ L ,P均<0 .0 1〕。治疗后黄芪注射液治疗组CD11b/ CD18表达(73.8±8.9)和ICAM 1含量〔(178.32±10 .4 6 )μg/ L〕均显著低于正常组〔分别为79.5±8.6和(196 .6 7±11.6 3) μg/ L,P均<0 .0 5〕。急性加重期COPD患者血清ICAM 1和CD11b/ CD18表达均与Pa O2 、一秒钟用力呼气量(FEV1)预测值、FEV1/用力肺活量(FVC)呈负相关,与Pa CO2 呈正相关。结论:ICAM 1增高和CD11b/ CD18表达增加参与了COPD的发生与发展,黄芪注射液具有抗白细胞黏附作用。

Objective: To study the relationship between adhesion molecule expression and chronic obstructive pulmonary disease(COPD), and to evaluate the effect of astragalus injection on antileukocyteadhesion aspect in patients with COPD.Methods: Fiftyeight patients were randomly divided into astragalus injection treatment group(n=30) and conventional treatment group(n=28). The expression of CD11b/CD18 were analyzed by flow cytometry and the levels of serum intercellular adhesion molecule1(ICAM1) were determined by enzyme linked immunosorbent assay(ELISA) in 58 cases of COPD and 20 healthy controls.Results: The expression of CD11b/CD18(86.1±9.8 and 76.6±8.2) and the level of serum ICAM1 〔(219.21±15.23)μg/L and (188.94±13.27)μg/L〕 in patients with COPD were significantly higher than those in the control subjects〔(132.37±16.59)μg/L, P<0.01〕.The expression of CD11b/CD18(73.8±8.9) and the level of serum ICAM1 〔(178.32±10.47)μg/L〕 after therapy in astragulas injection treatment group were significantly lower than those after therapy in control group〔79.5±8.6 and(196.67±11.63)μg/L, both P<0.05〕. In acute severe stage of COPD patients, ICAM1 conteat and CD11b/CD18 expression were negtive related to partial oxygen pressure(PaO 2), forced expiratory volume in one second(FEV1) predicted FEV1/forced vital capacity(FVC), and positively related to partial pressure of carbon oxide(PaCO 2). Conclusion: The increase of ICAM1 and expression of CD11b/CD18 may participate in the occurrence and development of COPD, and astragalus injection has a role on antileukocyteadhesion in this kind of patients.