红景天对高原地区老年慢性肺心病急性加重期抗氧化治疗的作用

Effect of rhodiola antioxidation in treating elderly patients with acute exacerbation of chronic cor pulmonale in high altitude area

目的探讨8-异前列腺素F2α(8-iso PGF2α)、超氧化物歧化酶(SOD)和丙二醛(MDA)与高原老年慢性肺心病发病的关系,以及红景天治疗高原老年慢性肺心病急性加重期的抗氧化作用。方法高原慢性肺心病急性加重期患者90例,随机分为2组,每组45例。红景天治疗组(A组):红景天加常规治疗,口服红景天胶囊,每次2.0g,3次/d;常规治疗组(B组):仅常规治疗。在治疗前和治疗后4周,分别测血清8-isoPGF2α、SOD、MDA、1s用力呼气容积(FEV1)占预计值的百分比(FEV1%)、FEV1/用力肺活量(FVC)比值(FEV1/FVC)、动脉血氧分压(PaO2)和动脉血二氧化碳分压(PaCO2)。并以40例当地健康人作对照(C组)。结果治疗前,A、B组血清8-isoPGF2α、MDA和PaCO2水平显著高于C组,SOD、FEV1%、FEV1/FVC和PaO2显著低于C组(均P<0.01),A、B组之间差异无显著性(均P>0.05)。A、B组血清8-isoPGF2α、MDA与FEV1%、FEV1/FVC、PaO2显著负相关,与PaCO2显著正相关(均P<0.01);SOD与FEV1%、FEV1/FVC、PaO2显著正相关,与PaCO2显著负相关(均P<0.01)。治疗后,A、B组血清8-isoPGF2α、SOD、MDA、FEV1%、PaO2和PaCO2均较治疗前显著改善(均P<0.01),但A组较B组改善更显著(均P<0.01)。结论高原老年肺心病急性加重期患者血清8-isoPGF2α和MDA水平显著升高,SOD水平显著降低,氧化/抗氧化失衡参与了高原老年肺心病的发病;红景天在高原老年肺心病急性加重期治疗中具有较好的抗氧化作用。

【Objectives】 To assess the relationship between change of serum 8-iso prostaglandin （PG） F2α （8iso PGF2α）,superoxide dismutase （SOD）,malondialdehyde （MDA） and incidence of elderly patients with acute exacerbation of chronic cor pulmonale in high altitude area （HAECCP） and to study the effect of rhodiola antioxidation in treating patients with acute exacerbation of HAECCP.【Methods】90 patients with acute exacerbation of HAECCP were randomly divided into 2 groups with 45 cases in each,a rhodiola therapy group （group A） （combination routine and rhodiola,2.0 g of rhodiola was given orally,three times daily） and a routine therapy group （group B） （routine treatment）.Level of serum 8-iso PGF2α,SOD,MDA,forced expiratory volume in 1 second （FEV1）,expressed as percentage predicted （FEV1%）,ratio of FEV1 to forced vital capacity （FEV1/FVC）,partial pressure of arterial O2 （PaO2） and partial pressure of arterial CO2 （PaCO2） were measured before and 4 weeks after treatment.Another,the upper mentioned parameters were measured in 40 healthy peoples （group C）.【Results】Before treatment,Level of serum 8-iso PGF2α,MDA and PaCO2 in group A and group B were significantly higher than those in group C,SOD,FEV1%,FEV1/FVC and PaO2 in group A and group B were significantly lower than those in group C （all P 0.01）,there were no differences between the in group A and group B （all P 0.05）.In group A and group B,level of serum 8-iso PGF2α,MDA was negatively correlated with FEV1%,FEV1/FVC,PaO2,positively correlated with PaCO2 （all P 0.01）,SOD was positively correlated with FEV1%,FEV1/FVC,PaO2,negatively correlated with PaCO2 （all P 0.01）.The after therapy,serum 8-iso PGF2,SOD,MDA,FEV1% ,PaO2 and PaCO2 in group A and group B were all markedly improved compared with those before treatment （all P 0.01）,those parameters in group A were markedly improved compared with those in group B （all P 0.01）.【Conclusion】 The level of serum 8-iso PGF2α,MDA were significantly increased and was significantly decreased in patients with acute exacerbation of HAECCP,and oxidant/ antioxidant imbalance may be involved in the pathogenesis of airway obstruction in HAECC.Rhodiola has better effects of antioxidation in patients with acute exacerbation of HAECCP.