慢性阻塞性肺疾病缓解期患者血浆P物质和血管活性肠肽水平与吸烟指数的相关分析

Association of substance P and vasoactive intestinal peptide concentration in plasma with smoking index in patients with chronic obstructive pulmonary disease at remission

目的:探讨神经源性炎症介质P物质和血管活性肠肽在慢性阻塞性肺疾病发病中的作用,采用单因素相关分析分析与吸烟指数的关系。方法:选择2002-12/2003-05复旦大学附属上海市第五人民医院呼吸科住院的慢性阻塞性肺疾病急性发作患者,排除因不能完成肺功能检查无法证实为慢性阻塞性肺疾病者。慢性阻塞性肺疾病缓解期患者组28例为急性发作期组患者经治疗症状缓解、实验室检查和/或X射线胸片改善4周以上者,男19例,女9例,年龄64～84岁,吸烟指数(773±121)年支。选择同期本院健康体检的退休职工30人为对照组,男20人,女10人,年龄60～78岁,吸烟指数(683±75)年支。所有纳入对象均知情同意。用放射免疫分析法观察患者组和对照组血浆P物质和血管活性肠肽水平。③变量间采用单因素直线相关分析。结果:慢性阻塞性肺疾病患者28例,健康体检者30人均进入结果分析。①血浆P物质水平:患者组明显高于对照组[(54.9±32.9),(39.7±19.9),(21.3±11.2)ng/L,t=4.08,3.51,P<0.01];急性期患者明显高于缓解期(t=1.97,P<0.05)。②血浆血管活性肠肽水平:患者组明显低于对照组[(9.7±7.7),(17.7±10.7),(32.8±15.5)ng/L,t=6.43,3.07,P<0.01];急性期患者明显低于缓解期(t=2.11,P<0.05)。③缓解期慢阻肺患者血浆P物质和血管活性肠肽水平均与吸烟指数无明显相关性(r=-0.204,-0.206,P>0.05)。结论:P物质和血管活性肠肽介导的神经源性气道炎症可能参与了慢性阻塞性肺疾病的发病过程,与吸烟指数无相关性。

AIM: To investigate the role of neurogenic inflammatory substance P and vasoactive intestinal peptide in the attack of chronic obstructive pulmonary disease at remission, and discuss the associations with smoking index by means of univariate correlation analysis. METHODS: Between December 2002 and May 2003, inpatients with chronic obstructive pulmonary disease at exacerbation (exacerbation group), who were hospitalized in the Department of Respiratory Medicine, Shanghai Fifth People's Hospital affiliated to Fudan University, were involved in this study, those, who were not able to be diagnosed to have chronic obstructive pulmonary disease for failed to complete the examination of pulmonary function, were excluded; 28 patients (19 males and 9 females) at 64 to 84 years of age in the remission group were those in the exacerbation group had relieved symptoms and ameliorations of laboratory examination and/or chest radiographic examination for more than 4 weeks, the smoking index was (773±121) year cigarettes. Thirty healthy physical examinees (20 males and 10 females) at 60 to 78 years of age, who were the retired employees of this hospital, at the same period were selected as controls (control group), the smoking index was (683±75) year cigarettes; All the subjects took part in this study voluntarily. The levels of substance P and vasoactive intestinal peptide in plasma were observed with the radioimmunoassay in the patient groups and control group. ③ Univariate linear correlation analysis was used for comparison among the variables. RESULTS: All the 28 patients with chronic obstructive pulmonary disease and 30 healthy physical examinees were involved in the analysis of results. ① Level of substance P in plasma: It was obviously higher in the patient groups than in the control group [(54.9±32.9), (39.7±19.9), (21.3±11.2) ng/L, t=4.08, 3.51, P < 0.01]; It was obviously higher in the exacerbation group than in the remission group (t=1.97, P < 0.05). ② Level of vasoactive intestinal peptide in plasma: It was obviously lower in the patient groups than in the control group [(9.7±7.7), (17.7±10.7), (32.8±15.5) ng/L, t=6.43, 3.07, P < 0.01]; It was obviously lower in the exacerbation group than in the remission group (t=2.11, P < 0.05). ③ Both the plasma levels of substance P and vasoactive intestinal peptide in patients with chronic obstructive pulmonary disease at remission had no obvious association with smoking index (r= -0.204, -0.206, P > 0.05). CONCLUSION: The substance P and vasoactive intestinal peptide mediated neurogenic airway inflammation may be involved in the attack process of chronic obstructive pulmonary disease, and have no association with smoking index.