不同时期慢性阻塞性肺疾病患者气道局部和全身氧化应激水平的变化

The variationin of the system and airway local oxidative stress in patients with chronic obstructive pulmonary disease at different stages

①目的探讨不同时期慢性阻塞性肺疾病(COPD)患者全身及气管局部氧化应激水平的变化及其与肺功能下降的关系。②方法对40例急性加重期COPD患者(A组),30例稳定期COPD患者(B组),15例健康吸烟者(C组)进行痰诱导及肺功能测定,并检测其血浆和诱导痰中MDA、GSH含量及SOD、GSH-PX的活性。③结果A组、B组、C组间血浆和诱导痰MDA含量均呈下降趋势;血浆和诱导痰GSH含量、SOD、GSH-PX活性呈上升趋势;血浆MDA、GSH含量,SOD、GSH-PX活性与肺功能FEV1相关系数分别为:-0.78、0.78、0.799、0.7383(P<0.05);诱导痰MDA、GSH含量,SOD、GSH-PX活性与肺功能FEV1相关系数分别为:-0.776、0.778、0.788、0.800(P<0.05)。④结论COPD患者在全身水平和气道局部均存在氧化/抗氧化失衡,尤以急性加重期患者更为明显;COPD患者氧化应激增加是导致肺功能下降的原因之一。

Objective To evaluate the variation of the system and airway local oxidative stress in patients with chronic obstructive , tive pulmonary disease （COPD） at different stages and the correlation with the level of lung function. Methods Sputum were induced and lung function were detected in 40 acute exacerbation of COPD （A group） , 30 stable COPD patients （B group）, and 15 normal subjects who smoked（ C group）. The content of MDA, GSH and the activity of SOD, GSH - PX in the plasma and induced sputum were detected. Results There was a downtrend in the content of MDA in plasma and induced sputum among A, B and C group,while there was a ascend trend in the content of GSH and the activity of SOD and GSH - PX in plasma and induced sputum. The correlation coefficient between FEV1 and the oxidative stress indicatrix（ MDA,GSH,SOD,GSH - PX） in the plasma were - 0. 78,0. 78 ,0. 799, 0. 7383, respectively（ P 〈 0.05 ）, while which in induced sputum ere - 0. 776,0. 778,0. 788,0. 800 respectively （ P 〈 0.05 ）. Conclusion There were an unbalance between oxidation and anti - oxidation in systematic and local oxidative stress in the COPD patients, especially in the acute exacerbation of COPD ; The increase of oxidative stress may be one cause leading to the decline of the FEV1 levels in the COPD patients.