N-乙酰半胱氨酸对老年慢性阻塞性肺疾病稳定期中细胞因子和T细胞亚群的影响

Influence of acetylcystein on the cytokines and T-lymphocyte subsets in elderly patients with stable chronic obstructive pulmonary diseases

目的:测定乙酰半胱氨酸在治疗慢性阻塞性肺疾病前后血清细胞因子浓度,T细胞亚群的变化,探讨乙酰半胱氨酸对气道炎症的影响。方法:选取老年慢性阻塞性肺疾病稳定期患者30例,应用乙酰半胱氨酸600mg,bid,连用4周,在治疗前后分别采用生物芯片技术测定血清中细胞因子,流式细胞仪测定血T淋巴细胞。记录平均每周咳嗽次数和咯痰费力程度。结果:乙酰半胱氨酸治疗后血清IL-6、IL-8浓度较治疗前下降,差异有显著性(P<0.05)。IL-2、MCP-1浓度和CD8比值较治疗前增高,差异有显著性(P<0.05)。IL-4、VEGF、IFNγ、TNFα和EGF浓度及CD3,CD4比值在治疗前后差异无显著性。治疗后咳嗽次数和咯痰费力均有不同程度地好转和减轻。结论:乙酰半胱氨酸干预治疗降低了有关细胞因子的炎症反应并增强了免疫功能,在抑制稳定期COPD的进行性发展中可能有比较重要的意义。

OBJECTIVE To investigate the changes of serum cytokines （IL-2,IL-4,IL-6,IL-8） and T- lymphocyte subsets （CD3, CD4, CD8） before and after taking A-cetylcystein（NAC） in the patients with COPD and evaluate the influence of NAC on the airway inflammation and clinical effects. METItOI）S 30 elderly patients in stable stage（grade Ⅱ-Ⅲ） of COPD were involved. Taking NAC 600rag bid for 4 weeks. Before NAC and after taking NAC 4 weeks, the serum level of cytokines （IL-4, IL- 6,IL-8; VEGF; IFN-γ; TNF-α; MCP-1; EGF） and T-lymphocyte subsets（CD3,CD4,CDS） were measured by bio-chip and flow cytometry respectively. Before and after treatment 4 weeks with NAC frequent of cough in average weeks were record. RE- SULTS After 4 weeks treatment with NAC the serum concentrations of IL-6,IL-8 were significantly lower （P〈0. 05） and IL- 2,MCP were significantly higher （P〈0. 05） than those before treatment. CD8 ratio was increased than before treatment （P〈 0. 05）. IL-4,VEGF, IFN-γ,TNF-α and EGF concentrations and CD3, CD4 ratio were no significantly changes before and after treatment. Frequent of cough were reduced during NAC was taken 4 weeks. CONCLUSION NAC inhibits inflammatory action by decreasing IL-6 and IL-8. It might play an impotent role to inhabit disease progression in stable COPD.