社区获得性肺炎患者血清及血小板γ-谷氨酰转肽酶活性和总抗氧化力水平的变化

Gamma-Glutamyltransferase Activity and Total Antioxidant Capacity in Serum and Platelets of Patients with Community-Acquired Pneumonia

目的观察社区获得性肺炎(CAP)患者血清及血小板γ-谷氨酰转肽酶(GGT)活性和总抗氧化力(T-AOC)水平的变化。方法以徐州医学院附属医院呼吸科2010年9月至2011年9月收治的90例CAP患者和30例体检健康者为研究对象。CAP患者根据外周血血小板计数分为继发血小板增多组(血小板计数>300×109/L)40例和血小板不增多组(血小板计数≤300×109/L)50例。检测研究对象的血清GGT、T-AOC及血小板GGT、T-AOC的水平。结果 CAP患者入院时血清GGT活性和血小板GGT活性[(45.6±25.4)U/L;(179.9±41.3)mU/109plt]均较对照组[(17.9±3.7)U/L;(49.5±8.0)mU/109plt]高;血清T-AOC入院时[(12.6±1.6)U/mL]比对照组[(17.8±2.1)U/mL]低;血小板T-AOC入院时[(61.6±21.5)mU/109plt]高于对照组[(48.6±9.9)mU/109plt];血小板T-AOC出院时[(40.7±14.2)mU/109plt]比入院时[(61.6±18.3)mU/109plt]和对照组[(48.6±9.9)mU/109plt]均低,差异均有统计学有意义(P<0.05)。血清T-AOC血小板增多组[(12.9±1.1)U/mL]比血小板不增多组[(12.3±1.7)U/mL]高;血小板T-AOC血小板增多组[(53.0±12.0)mU/109plt]比血小板不增多组[(68.6±19.7)U/109plt]低,血清GGT血小板增多组[(52.5±31.6)U/L]比血小板不增多组[(39.7±15.8)U/L]高,血小板GGT血小板增多组[(166.4±39.3)mU/109plt]比血小板不增多组[(190.6±39.9)mU/109plt]低,差异均有统计学意义(P均<0.05)。入院时血小板计数与血小板T-AOC、GGT呈负相关,相关系数分别为-0.316(P=0.003),-0.308(P=0.002)。结论在炎症反应过程中血小板活化与氧化应激有关;血小板在炎症反应过程及维持氧化抗氧化平衡中发挥作用。

Objective To observe the gamma-glutamyhransferase （GGT） activity and total antioxidant capacity （T-AOC） in serum and platelet during the course of community-acquired pneumonia （CAP）. Methods Ninety cases of hospitalized CAP were recruited from the respiratory wards in the Affiliated Hospital of Xuzhou Medical College from September 2010 to September 2011, and 30 healthy cases who underwent physical examination in the same hospital were enrolled as control. GGT activity and T-AOC were compared between the CAP patients and the control subjects, and also between the CAP patients who developed reactive thrombocytosis （platelet count 〉 300 × 10^9/L） and those without thrombocytosis （platelet count ≤300 × 10^9/L）. Results Compared with the control subjects,serum and platelet GGT activity of the CAP patients were significantly higher [ （ 45.6 ± 25.4 ） U/L vs. （ 17.9 ± 3.7 ） U/L, （ 179. 9 ± 41.3 ） mU/10^9 plt vs. （49. 5 ± 8.0 ） mU/10^9 ph, P 〈 0. 05 ], serum T-AOC at admission was significantly lower [ （ 12. 6 ± 1.6 ） U/mL vs. （ 17.7 ± 2. 1 ） U/mL, P 〈 0.05 ], and platelet T-AOC at admission was significantly higher [ （61.6 ± 18. 3 ） mU/10^9 pit vs. （48. 6 ± 9. 9 ） mU/10^9 pit, P 〈 0. 05 ]. Platelet T-AOC of the CAP patients at discharge was significantly lower than that of the CAP patients at admission and thecontrol subjects. Compared with the CAP patients without thrombocytosis, serum T-AOC and serum GGT activity of the CAP patients who developed reactive thrombocytosis were significantly higher（P 〈 0.05 ） ,and platelet T-AOC and platelet GGT activity were both significantly lower （ P 〈 0.05 ）. There were negative correlations of the platelet count with platelet T-AOC and GGT activity in the CAP patietns（r = -0. 316, P = 0.003 ; r = - 0. 318,P = 0. 002）. Conclusions There is a correlation between the oxidative stress and the platelet function in the inflammatory process of CAP. There might be an indicative role of platelets in resolving the inflammatory process and in maintaining the oxidative-antioxidative balance.