汉防己甲素对慢性阻塞性肺疾病急性加重期血和诱导痰中瘦素及瘦素受体表达的影响

Effects of tetrandrine on the expression of leptin and leptin receptor in acute exacerbation phase in chronic obstructive pulmonary diseases patients

目的探讨汉防己甲素对慢性阻塞性肺疾病（COPD）急性加重期患者局部瘦素及瘦素受体表达的影响。方法按照入院顺序编号将80例患者分为2组：汉防己甲素治疗组与经典治疗组各40例。采用酶链免疫方法测定治疗前后血清及诱导痰瘦素（Leptin）、可溶性瘦素受体（sLR）、白细胞介素8（IL-8），并同时测定血清C反应蛋白（CRP），肺功能、血气分析等，对上述指标进行对比分析。结果2组治疗前比较：Leptin、sLR、IL-8及血清CRP差异无统计学意义，治疗后汉防己甲素治疗组Leptin、sLR、IL-8及血清CRP比经典治疗组下降明显，差异有统计学意义[（4．16±0．22，24．45±0．73，25．35±0．35，16．09±0．86）vs（7．76±0．19，28．97±10．11，19．99±0．97），P〈0．05或P〈0．01]，诱导痰Leptin与血清Leptin呈正相关（P〈0．05），而与血清sLR、IL-8、CRP无统计学意义（P〉0．05）。结论汉防己甲素能改善急性加重COPD患者的全身及气道局部炎症状态，同时下调瘦素、瘦素受体、IL-8、CRP的水平。

Objective To investigate the effect and role of the tetrandrine on the expression of leptin and leptin receptor of patient with COPD in systemic and local on acute exacerbation phase. Methods Eighty patients with COPD were randomly divided into two study groups： tetrandrine treating group（ first group n = 40） and routine treating group（ second group n =40）. The expression of leptin and the leptin receptor, IL-8 in serum and in induced sputum were measured by enzyme linked immunosorbent assay （ELISA）, CRP was measured by turbidimetry. Blood gas analysis, pulmonary function testing was done routinely. Result There were no significant differences between two groups in the leptin, leptin receptor, IL-8, CRP in serum and the leptin, leptin receptor, IL-8 in the induced sputum before the treatment. Those indexes were significantly lower in the first group than in the the second group after treatment （P 〈 0.05 and P 〈 0.01 ）. Significant correlations were found among the leptin in induced sputum and leptin in serum and leptin receptor, IL-8 in induced sputum. Leptin in induced sputum did not correlate with leptin receptor and IL-8 and CRP in serum. Conclusions The leptin is involved in the system and airway flammatory prespose of the acute exacerbation phase with COPD. Tetrandrine can improve the systemic and local inflammation and down-regulate the expression of leptin, leptin receptor and IL-8, CRP on the patient in acute exacerbation phase with COPD.