丙氨酰-谷氨酰胺对AECOPD患者CD4＋、CD8＋淋巴细胞及IL-8、TNF-α的影响

Effects of alanyl-glutamine on CD4＋, CD8＋ lymphocyte, IL-8, TNF-α of patients with AECOPD

目的 观察静脉补充丙氨酰-谷氨酰胺（AG）对慢性阻塞性肺疾病急性加重（acuteexacerbation of chronic obstructive pulmonary disease,AECOPD）患者CD4＋/CD8＋T细胞及IL-8、TNF-α的影响.方法 通过静脉对AECOPD患者补充丙氨酰-谷氨酰胺,ELISA法检测IL-8、TNF-α表达水平,流式细胞仪检测CD4＋、CD8＋、CD3＋淋巴细胞变化.结果 与对照组比较,丙氨酰-谷氨酰胺治疗组（AG组）临床缓解率高于对照组（93.33％vs 73.33％）;治疗后AG组IL-8[（102.11±13.57） ng/ml]、TNF-α[（0.83±0.26）μg/L]水平低于对照组[（137.46±12.9） ng/ml、（1.34±0.42）μg/L],两组比较差异有统计学意义（P＜0.05）;治疗后,两组CD4＋/CD8＋比值比较差异无统计学意义,但AG组CD3＋淋巴细胞绝对值（0.69×109/L）高于对照组（0.50×109/L） （P＜0.05）.结论 谷氨酰胺可促进AECOPD患者T淋巴细胞的增殖,并同时减少IL-8、TNF-α的表达,从而可能对AECOPD起到治疗作用.

Objective To observe the changes of CD4＋,CD8＋ lymphocyte,IL-8 and TNF-o of patients with acute exacerbation of chronic obstructive pulmonary disease （AECOPD） after intravenous feeding of alanylglutamine.Methods We supplemented alanyl-glutamine by phleboclysis for AECOPD patients.The level of IL8,TNF-α were tested by enzyme-linked immunosorbent assay （ELISA）,and CD4＋ and CD8＋ lymphocyte in peripheral blood were detected by flowcytometry in AECOPD patients.SPSS 13.0 software was used to analyze the data.Results Compared to control group,the rate of clinical remission in alanyl-glutamine therapy group was higher （93.33％ vs 73.33％）.On the 7th day,the levels of IL-8 （102.11 ± 13.57） ng/ml TNF-α （0.83 ± 0.26） μ g/ L in AG therapy group were lower than those in control group （137.46 ± 12.9） ng/ml and （1.34 ± 0.42） μ g/L,all P ＜ 0.05; but the number of CD3＋ lymphocyte in AG therapy group （0.69 × 109）/L was more than that of control group （0.50 × 109）/L,P ＜ 0.05.There was no statistical significant difference in the ratio of CD4＋/CD8＋ lymphocyte between AG therapy group and control group.Conclusion Glutamine can boost the proliferation of T lymphocyte,at the same time,reduce the expression of IL-8 and TNF-o,thus making it have treatment effect on AECOPD.