慢性支气管炎局部神经功能紊乱对肺泡巨噬细胞的影响

Influence of local nerve function disorder from patients with chronic bronchitis on alveolar macrophage

目的探讨肾上腺素神经和胆碱能神经在慢性支气管炎中的作用及作用机制。方法分别检测慢性支气管炎(慢支)组、慢性支气管炎合并肺气肿组患者和正常对照组外周血、支气管肺灌洗液(BALF)中胆碱脂酶(ChE)和去甲肾上腺素(NE)的含量,支气管肺泡灌洗液肺泡巨噬细胞内环磷酸腺苷(cAMP)及环磷酸鸟苷(cGMP)含量。结果慢支组与正常组BALF中ChE无显著差异,而NE升高;在慢支合并肺气肿组患者BALF中ChE较正常组增高,而NE较正常对照组少;慢支组BALFAM内cAMP/cGMP比值正常,而慢支合并肺气肿组AM内cAMP/cGMP较正常对照组明显降低,β2受体激动剂(舒喘灵)作用于AM后,慢支组cAMP/cGMP比值上调,而慢支肺气肿组AM内cAMP/cGMP比值无明显变化。结论肾上腺素神经、胆碱能神经及肾上腺素受体参与了慢性支气管炎的发生发展过程,在不同的疾病阶段其作用不同。

Objective Discussing the role and mechanism of adrenergic and cholinergic autonomic nerves in chronic bronchitis. Methods Examing the levels of cholinesterase （CHE） and noradrenalin （NE） in serum, bronchoalveolar lavage fluid（BALF） and cAMP, cGMP in alveolar macrophage（AM） from patients with chronic bronchitis combined with emphysema, chronic bronchitis and normal subjects. Results Compared with normal subjects, the amount of CHE in BALF from patients with chronic bronchitis was no difference, but NE was higher. The mount of CHE in BALF from patients with chronic bronchitis combining emphysema was higher, but the NE was lower, compared with normal subjects. The rate of cAMP/cGMP in AM from patients with chronic bronchitis was normal, but the rate from chronic bronchitis combining emphysema was lower, compared with normal subjects. After β2-receive body excited dose roling on AM, the rate of cAMP/cGMP in patients from chronic bronchitis was higher, but the rate from chronic bronchitis combining emphysema was normal. Conclusion Adrenergic, cholinergic autonomic nerver and adrenergic receptor play different roles in different periods of chronic bronchitis, and play an important role in the development of chronic bronchitis.