慢性阻塞性肺疾病患者血浆氧化剂和抗氧化剂的变化研究

Oxidant-antioxidant balance in chronic obstructive pulmonary disease

目的观察氧化物和抗氧化系统之间的不平衡对慢性阻塞性肺疾病(chronic obstructive pulmonary dieases,COPD)的影响。方法所有研究对象均为深圳龙岗中心医院2012年10月—2013年10月就诊患者及体检人员,COPD急性加重期组30例,稳定期组30例,选取30例未吸烟来院健康体检人员作为对照组。检查包括肺功能测定、评估氧化应激的生物标志物:丙二醛(malonaldehyde,MDA),抗氧化剂:维生素C和酶抗氧化剂超氧化物歧化酶(superoxide dismutase,SOD)。三组间资料比较采用单因素方差分析,两组间的比较采用独立样本t检验,以P<0.05为差异有统计学意义。结果 COPD患者(急性发作期和稳定期)血浆MDA水平[(9.68±3.23)、(7.69±1.34)nmol/ml]明显高于健康组(P<0.05),COPD急性发作期MDA水平高于稳定期患者(P<0.05),急性发作期COPD患者吸烟者MDA水平[(8.97±1.42)nmol/ml]高于非吸烟或戒烟患者(P<0.05),而稳定期COPD患者吸烟者MDA水平与非吸烟或戒烟者相比差异无统计学意义(P>0.05)。COPD(急性发作期或稳定期)患者维生素C、SOD水平明显低于健康对照组(P<0.05),COPD患者急性发作期维生素C、SOD水平较稳定期低(P<0.05),COPD急性发作期患者吸烟者血浆维生素C、SOD水平比未吸烟者或戒烟者低(P<0.05),COPD稳定期患者,未吸烟或戒烟组与吸烟组比较,血浆维生素C、SOD水平差异无统计学意义(P>0.05)。结论氧化应激在COPD是一个重要的病理生理变化。吸烟对COPD急性加重期的氧化应激及氧化剂-抗氧化剂系统有影响。

Objective The aim of the study was to observe the effects of oxidant - antioxidant imbalance on COPD. Methods All subjects were from patients treated or taking physical examination in our hospital from Oct. 2012 to Oct. 2013. Of which, there were 30 cases of AECOPD, 30 cases of stable COPD, and 30 healthy nonsmokers in this study. All subjects were checked for their lung function, malondialdehyde （ MDA, a biomarker of oxidative stress） , and antioxidants （vitamin C and superoxide dismutase）. One - way analysis of variance was used to compare data among three groups, and independent - samples t test to compare data between the two groups, the result of P 〈 0.05 was considered statistically significant. Results The level of MDA was found to be significantly higher in COPD patients （ stable or AECOPD） [ （9.68 ± 3.23 ）, （ 7.69 ± 1.34） nmol/ml ] when compared with healthy group （ P 〈 0.05 ）. It is also found the level of MDA was significantly higher in patients with AECOPD than in stable COPD （P 〈 0.05）. Smokers with AECOPD had a higher level of MDA[ （ 8.97 ±1. 42） nmol/ml] than non - smokers or quit - smoking patients （ P 〈 0.05 ） , while for patients stable COPD, the level of MDA showed no statistical difference from those of non - smokers or quit - smoking patients （ P 〉 0. 05 ）. The levels of Vit C and SOD were significantly lower in COPD patients （ stable or AECOPD） than in the healthy con- trois（ P 〈 0.05）. The levels of Vit C and SOD were significantly lower in AECOPD patients than in those with stable COPD （ P 〈 0.05）. The levels of Vit C and SOD were significantly lower in smokers with AECOPD than in non - smokers（ P 〈 0. 05）. Patients with stable COPD（ non -smokers or quit -smoking patients） and smoker groups showed no statistically sig- nificant difference in the levels of Vit C and SOD （ P 〉 0.05 ）. Conclusions Oxidative stress is an important pathophysio- logical change in COPD. Smoking has influence on oxidative stress and oxidant - antioxidant balance in AECOPD.