慢性阻塞性肺疾病急性加重期与稳定期体内NF-κB及可溶性细胞间黏附分子的变化及意义

NF-κB p65 expression and plasma sICAM- 1 levels in COPD patients with acute exacerbation and remission

目的探讨痰巨噬细胞中NF-κB p65的表达及血浆中可溶性细胞间黏附分子（sICAM-1）在慢性阻塞性肺疾病（COPD）急性加重期、稳定期中的变化与相关性，为临床治疗提供依据。方法选取32例COPD患者（均为急性加重后经治疗转为稳定期）及30例体检健康对照者，诱导痰后采用免疫组织化学染色法检测巨噬细胞中NF-κB p65的表达，同时采用ELISA法检测血浆sICAM-1水平，然后作比较分析。结果与对照者比较，COPD患者急性加重期及稳定期痰巨噬细胞中NF-κB p65的表达和血浆sICAM-1水平均明显较高（P〈0.05或0.01）；与稳定期比较，COPD患者急性加重期痰巨噬细胞中NF-κB p65的表达和血浆sICAM-1水平均显著较高（均P〈001）。直线相关分析结果显示，痰巨噬细胞中NF-κB p65的表达与血浆sICAM-1水平呈显著正相关（r=0.538，P〈0.01）。结论NF-κB、sICAM-1在COPD急性加重期呈较高水平表达，两者在COPD气道炎症及阻塞的发生、发展过程中可能起着重要作用，NF-κB可能是通过上调sICAM-1的表达而介导更频繁的白细胞黏附活动发挥作用的。

Objective To investigate the expression of nuclear factor kappa-B （NF - K B） P65 in sputum macropolycytes and plasma soluble intercellular adhesion molecule （sICAM-1） in patients with chronic obstructive pulmonary disease（COPD） during the stage of acute exacerbation and remission. Methods The expression of NF-κ B was detected by immunocytochemical staining and plasma sICAM- 1 was measured by ELISA in 32 COPD patients with acute exacerbation and remission stage, 30 healthy age-matched subjects. Results The positive rate of NF-κB in sputum macropolycytes and the plasma levels of sICAM- 1 in COPD with acute exacerbation were remarkably higher than those in COPD with remission stage （P〈0.01） and in normal controls （ P〈0.05 and 0.01）. There was a positive correlation between percentage of positive NF-κB karyotin cell and plasma levels of sICAM- 1 （r=0.538,P〈0.01）. Conclusion Up-regulation of NF-κB and high plasma sICAM-1 may be involved in the process of airway inflammation and airway obstruction in COPD.