胞质型磷脂酶A2α与慢性阻塞性肺疾病的关系

Research on relationship between cytosol phospholipase A2α and chronic obstructive pulmonary disease

目的：探讨慢性阻塞性肺疾病（COPD）患者体内胞质型磷脂酶A2α（cPLA2α）和一氧化氮（NO）的变化及意义。方法选取天津中医药大学附属武清中医院重症医学科收治的COPD患者100例，按照COPD严重程度分级标准分为轻度组25例，中度组25例，重度组26例，极重度组24例，以同期90例肺功能正常的健康体检者为健康对照组。用酶联免疫吸附试验（ELISA）检测受试者cPLA2α水平；用酶法检测各组受试者血尿酸（UA）、总胆固醇（TC）及三酰甘油（TG）水平；用硝酸还原酶法测定血清NO代谢产物硝酸盐和亚硝酸盐（NOx）。结果与健康对照组比较，不同严重程度COPD各组血清cPLA2α和血UA水平均显著升高；随着COPD分级严重程度加重，COPD轻、中、重、极重度组患者cPLA2α、UA水平逐渐升高、NOx水平逐渐下降〔cPLA2α（ng/L）：125.60±8.17、155.20±6.42、190.20±9.32、255.80±11.28比88.50±7.99，UA（μmol/L）：381.23±32.22、434.95±87.71、464.81±52.65、487.45±82.61比241.95±52.33，NOx（μmol/L）：59.90±17.52、45.60±6.17、38.20±4.08、25.70±3.04比74.90±18.31，均P＜0.05〕。不同严重程度COPD各组间血cPLA2α和血清NOx水平差异均有统计学意义（P＜0.05）。各组TC、TG水平比较差异均无统计学意义（均P＞0.05）。cPLA2α和NOx水平呈显著负相关（rs＝-0.798，P＝0.013）。结论联合检测血中cPLA2α和NOx可诊断COPD严重程度，cPLA2α可以作为COPD分级的新靶标。

Objective To approach the changes of cytosol phospholipase A2α（cPLA2α）and nitric oxide （NO）in patients with chronic obstructive pulmonary disease（COPD）and its significance. Methods One hundred patients with COPD admitted into Department of Critical Care Medicine of Affiliated Wuqing Traditional Chinese Medicine（TCM）Hospital of Tianjin University of TCM were enrolled,and according to the COPD severity grading standards,they were divided into mild group（25 cases）,moderate group（25 cases）,severe group（26 cases） and extremely severe group（24 cases）;simultaneously,90 cases with normal pulmonary function who had taken health examination were chosen and assigned to the healthy control group. The cPLA2α level was detected by enzyme linked immunosorbent assay（ELISA）,the level of uric acid（UA）,total cholesterol（TC）,triacylglycerol （TG）were detected by enzymatic method,and serum NO metabolites（NOx）level was detected by nitrate reductase method. Results Compared with the healthy control group,the serum levels of cPLA2α and UA in patients with different severity of COPD were significantly increased;along with the increase of patient＇s COPD grade of severity,the cPLA2α,UA levels were gradually increased,while NOx level was gradually decreased in mild, moderate, severe, extremely severe groups〔cPLA2α（ng/L）：125.60±8.17, 155.20±6.42, 190.20±9.32, 255.80±11.28 vs. 88.50±7.99;UA（μmol/L）：381.23±32.22,434.95±87.71,464.81±52.65,487.45±82.61 vs. 241.95±52.33;NOx（μmol/L）：59.90±17.52,45.60±6.17,38.20±4.08,25.70±3.04 vs. 74.90±18.31,all P〈0.05〕. The differences in blood cPLA2αand serum NOx level among groups with different severity of COPD were of statistical significance（P〈0.05）. The levels of TC,TG among these different severity groups had no statistical significance（all P〉0.05）. The cPLA2αand NOx levels presented significant negative correlation（rs=-0.798,P=0.013）. Conclusion The combined examination of blood cPLA2αand serum NOx levels can evaluate the severity degree of COPD patients,and cPLA2αcan be used as a new target index for COPD grading.