慢性阻塞性肺疾病患者对氧磷酶和氧化应激与全身炎性反应的研究

Relationship of serum paraoxonase and oxidative stress with systemic inflammatory response in patients with chronic obstructive pulmonary disease

目的探讨慢性阻塞性肺疾病（COPD）患者在急性期与稳定期血清对氧磷酶（PON1）的变化及其与氧化应激、全身炎性反应的关系。方法对38例COPD患者在急性期和稳定期血清的PON1活性采用乙酸苯酯法检测，改良Hafeman法检测血清谷胱甘肽过氧化物酶（GSHPx）活性，比色法测定总抗氧化能力（TAC），硫代巴比妥酸显色法测定丙二醛（MDA）水平，放射免疫法测定血清白介素-6（IL-6）和白介素-8（IL-8）水平，免疫投射比浊法测定血清C反应蛋白（CRP）含量。结果COPD急性期患者血清PON1活性（98．03±42．40）×10^3U／L显著低于健康对照组的（136．00±60．50）×10^3U／L（t=4．962，P〈0．01），COPD急性期患者PON1活性与IL-8水平呈显著负相关（r=-0．589，P〈0．01），与FEV1％呈正相关（r=0．434，P〈0．05）；GSH—Px活性与IL-6水平呈负相关（r=-0．362，P〈0．05）；COPD稳定期患者血清PON1活性（131．50±53．65）×10^3U／L与健康对照组（136．00±60．50）×10^3U／L比较，差异无统计学意义（t=2．457，P〉0．05），GSHPx活性与IL-8水平呈负相关（r=-0．563，P〈0．05）。结论COPD急性期患者PON1活性明显降低，与FEV1％存在正相关，且氧化应激与全身炎性反应之间密切相关。

Objective To analyze the activity of paraoxonase （PON1） and explore the relationship of PON1 and oxidative stress with systemic inflammation response in the acute exacerbation phase and stationary phase in patients with chronic obstructive pulmonary disease （COPD）. Methods Serum PON1 activity was measured by phenylacetate in 38 patients with COPD and 30 healthy people. The activity of glutathione peroxidase （GSH-Px） was detected by improved Hafeman method. Total antioxidant capacity （ TAC ） was measured by colorimetry and malondialdehyde （MDA） level was measured by thiobarbituric acid colouration method. The interleukin-6 （IL-6） and interleukin 8 （IL 8） levels were detected by radioimmunoassay. The level of C-reactive protein （CRP） was measured by immune turbidimetry. Results In the acute exacerbation phase, the activity of serum PON1 was significantly lower in COPD group than in control group[（98.03±42.40）×10^3U/Lvs. （136.00±60.50）×10^3U/L, t 4.962, P〈0.01], anditwas negatively related to the IL-8 level （r=-0.589, P〈0.01） and positively related to FEV1%（r= 0. 434, P〈0.05）. The activity of GSH-Px was negatively related to the IL 6 level （r=-0. 362, P〈 0.05）. In the stationary phase of COPD group, the activity of serum PON1 had no statistical difference compared with control group[（131.50±53.65）×10^3U/L vs. （136.00±60.50）×10^3U/ L, t=2. 457, P〉0.05], and it was negatively related to the IL-8 level （r=-0. 563, P〈0.05）. Conclusions Serum PON1 activity is significantly decreased in acute exacerbation phase of COPD group compared with control group and it is positively related to FEV1 G. The oxidative stress is closely related to systemic inflammation response in patients with acute exacerbation of COPD.