AECOPD患者白三烯B_4和α-肿瘤坏死因子的变化及治疗对其的影响

Changes of LTB_4 and TNF-α in patients with AECOPD

目的探讨COPD急性加重(AECOPD)患者白三烯B4和α-肿瘤坏死因子的改变和治疗对其的影响。方法随机抽取门诊稳定期COPD患者39例和住院的AECOPD患者43例,检测稳定期患者和AECOPD患者治疗前后血气分析、WBC、CRP、PROBNP、肺功能及血和诱导痰中LTB4和TNF-α的量。结果AECOPD患者PaCO2显著高于稳定期患者。两组肺功能无显著差异。WBC、CRP、PROBNP均无显著差异。AECOPD患者血LTB4和诱导痰LTB4均高于稳定期和治疗后。且治疗后LTB4显著低于治疗前;急性加重期患者治疗后血TNF-α显著低于稳定期患者,急性加重期患者治疗后诱导痰TNF-α明显低于治疗前和稳定期患者。结论 LTB4和TNF-α参与了AECOPD患者的发病过程,抗感染治疗可能降低LTB4,在诱导痰中表现最明显。而TNF-α的作用目前尚不明确。

Objective To explore the changes of leukotriene B4 （ LTB4 ） and tumor necrosis factorα（ TNF-α） in patients with AECOPD as well as the effect of treatment. Methods 39 COPD patients at stable stage and 43 AECOPD patients were taken in this study. The clinical symptoms, physical signs, blood gas analysis, WBC, CRP, PROBNP, pulmonary function （ FEV1 and FEV1/FVC） , and LTB4 and TNF-α in blood and induced sputum of all patients were analyzed before and after the treatment. Results The level of PaCO2 was significantly higher in the study group than in the control group. There was no obvious difference in pulmonary function, WBC, CRP and PROB-NP in the two groups. The level of LTB4 in both blood and induced sputum was higher in the study group than in the control group, and the level of TNF-αwas significantly lower in the study group than in the control group. Conclusion LTB4 and TNF-αare involved in the development progress of AECOPD patients. Anti-infection treatment can lower the level of LTB4 , especially in terms of induced sputum. However, the role of TNF-αis not clear so far.