慢性阻塞性肺疾病患者血清中微量元素浓度变化及作用

The Change of Serum Copper and Zinc Levels in Patients with Chronic Obstructive Pulmonary Disease and Its Function

目的探讨慢性阻塞性肺疾病(COPD)患者中微量元素铜和锌与炎症介质的关系。方法 2010年11月-2011年3月间测量15例COPD急性加重期患者入院时及治疗后和13例健康者为对照组的血清铜、锌、C反应蛋白(CRP)、白介素-6(IL-6),血浆中金属硫蛋白,以及氧化应激产物丙二醛的浓度变化。并对铜、锌浓度变化与CRP、IL-6进行相关分析。结果 COPD组血清中铜浓度、CRP、IL-6水平高于对照组(P<0.05),同时急性加重期患者血清中铜的浓度、CRP、IL-6水平以及丙二醛值高于缓解期患者(P<0.05)。而急性加重期患者血清中锌浓度低于缓解期组和对照组(P<0.05)。血浆中抗氧化物质金属硫蛋白在三组间差异无统计学意义(P>0.05)。在微量元素与炎症因子的相关分析中发现,铜与CRP(r=0.602,P<0.001)、IL-6(r=0.533,P<0.001)呈正相关,锌与IL-6呈负相关(r=0.336,P<0.05)。结论在COPD氧化应激发病机制中,铜可能发挥促氧化应激的作用,而锌可能发挥抗氧化应激的作用。微量元素稳态的紊乱有可能是COPD急性加重的危险因素。

Objective To elucidate the correlation between trace element levels and inflammatory factors in patients with acute exacerbations of chronic obstructive pulmonary disease（AECOPD） by measuring the concentrations of serum copper,zinc,C-reactive protein（CRP）,and interleukin-6（IL-6） in these patients during acute exacerbation and remission periods.Methods Between November 2010 and March 2011,15 patients with AECOPD and 13 healthy controls were recruited in this study.The serum concentrations of copper,zinc and inflammatory factors（CRP,IL-6） in AECOPD patients before and after treatment,and in the healthy controls were measured.Furthermore,the antioxidant（metallothionein,MT） and an indicator of oxidative stress（malondialdehyde,MDA） in plasma were also measured.Meanwhile,correlations among copper,zinc and inflammatory factors were analyzed.Results Serum copper concentration and inflammatory factor levels were higher in patients with COPD than in the healthy controls（P〈0.05）.Patients with acute exacerbations had significantly higher values of copper,inflammatory factors and MDA compared with patients with remission of AECOPD（P〈0.05）.Conversely,lowered zinc concentration was observed in patients with acute exacerbations（P〈0.05）.But the MT concentration was not significantly different among the three groups（P〈0.05）.Positive correlations were found between copper and CRP（r=0.602,P〈0.001） and between IL-6 and copper（r=0.533,P〈0.001） in all COPD patients and healthy controls.And we observed an inverse correlation between zinc and IL-6（r=？0.336,P〈0.05）.Conclusions There are positive correlations between copper and CRP,IL-6,and negative correlations between zinc and IL-6.It suggests the probable prooxidative effect of copper ions,whereas zinc ions may be antioxidant element in COPD.The disordered trace element homeostasis leads to pathological oxidant stress,and may be a risk factor in AECOPD.