慢性阻塞性肺疾病血小板5-羟色胺变化及意义

Change of platelet 5-HT level in chronic obstructive pulmonary disease patients

目的探讨慢性阻塞性肺疾病(COPD)患者血小板5-羟色胺(5-HT)水平变化及意义。方法按入选、排除标准,选择COPD患者51例,对照组为同期健康体检者49例。测定COPD组第1秒用力呼气量,用力肺活量及第1秒用力呼气量/用力肺活量;用超声多普勒方法测定肺动脉收缩压(PASP);用反相高效液相方法检测COPD组和对照组血小板5-HT浓度。结果 COPD组无论是急性发作期还是稳定期血小板内5-HT浓度均明显低于对照组(P<0.01);COPD组患者不同严重程度分级(Ⅱ、Ⅲ和Ⅳ级)对5-HT浓度没有明显影响;COPD组伴有肺动脉高压(PAH)患者的血小板5-HT水平明显低于COPD不伴有PAH患者(P<0.05);在COPD伴PAH患者中,轻度和中度PAH患者血小板5-HT没有明显差别,重度PAH患者5-HT浓度有降低趋势,但没有达到统计学意义。血小板5-HT浓度与PASP具有负相关性(相关系数r=-0.368)。结论在COPD病理状态下,尤其是伴有肺动脉高压的COPD,血小板内5-HT浓度明显降低,且与肺动脉高压有相关性。5-HT作为一种血管活性物质,其可能对促进COPD形成及诱发晚期PAH有重要作用。

【Objecive】 To investigate the platelet 5-HT level in chronic obstructive pulmonary disease（COPD） patients.【Methods】 51 COPD patients and 49 health controls were collected.The pulmonary function test including FEV1,FVC and FEV1/FVC% were performed in COPD patients.Pulmonary systolic arterial pressure（PASP） was measured by three-dimensional color Doppler ultrasonography.And platelet 5-HT levels in COPD and control group were assayed by high performance liquid chromatography（HPLC）.【Results】 In COPD group,no matter acute exacerbation phase or stable phase,platelet 5-HT levels were significant lower than control group（P 0.01）.But there was no relationship between platelet 5-HT levels and severity of COPD（Ⅱ,Ⅲ,Ⅳ） in patients.Compared with COPD without pulmonary arterial hypertension（PAH） patients,platelet 5-HT levels were reduced in COPD with PAH patients（P 0.05）,and 5-HT levels were lower in COPD with severity PAH patients than with mild PAH patients,although there was no statistics difference.There was a negative correlation between platelet 5-HT level and PASP（r =-0.368）.【Conclusions】 In COPD group,especially COPD with PAH,platelet 5-HT level was significantly decreased,and 5-HT level has correlation with PAH.5-HT as an important vasoactive substance may play important roles in the development of COPD,especially promote PAH in advanced stage of COPD,which maybe an index to evaluation the risk of COPD with PAH and the severity of PAH.