内皮细胞膜微粒在慢性阻塞性肺疾病中的表达及意义

Expression and significance of endothelial microparticles in chronic obstructive pulmonary disease

目的探讨内皮细胞膜微粒（EMPs）在慢性阻塞性肺疾病（COPD）中的表达及意义。方法选取本院2013年10月~2014年7月收治的30例COPD急性加重期患者作为AECOPD组,选取同期的30例COPD稳定期患者作为COPD稳定期组,选取同期的30例无COPD健康志愿者作为对照组,检测其EMPs水平。结果 COPD稳定期组与对照组的PECAM、VE-cadherin及E-selectin水平显著低于AECOPD组,差异有统计学意义（P〈0.01）。对照组的PECAM、VE-cadherin及E-selectin水平显著低于COPD稳定期组,差异有统计学意义（P〈0.01）。在30例COPD稳定期患者中,10例有反复急性加重病史。有急性加重病史组的PECAM、VE-cadherin、E-selectin水平显著高于无急性加重病史组,差异有统计学意义（P〈0.01）。结论 COPD急性加重期内皮损伤主要在肺毛细血管,高基线E-selectin、VE-cadherin及PECAM水平预示着COPD患者容易急性加重。EMPs可作为COPD急性加重的易感性标志物。

Objective To explore the expression and significance of endothelial microparticles（EMPs） in chronic obstructive pulmonary disease（COPD）. Methods 30 patients with acute exacerbation of COPD in our hospital from October 2013 to July 2014 were selected as the AECOPD group,30 patients with COPD in the stable period during the same period were selected as the COPD stable stage group,30 cases of healthy volunteers without COPD during the same period were selected as the control group.The level of EMPs was detected. Results The level of PECAM,VE-cadherin,E-selectin in the COPD stable stage group and the control group was lower than that in AECOPD group,with significant difference（P〈0.01）.The level of PECAM,VE-cadherin,E-selectin in the control group was lower than that in the COPD stable stage group,with significant difference（P〈0.01）.Among 30 patients with COPD in the stable period,10 cases had a history of repeated exacerbations.The levels of PECAM,VE-cadherin,E-selectin in COPD patients with a history of acute exacerbation was higher than patients without a history of acute exacerbation,with significant difference（P 〈0.01）. Conclusion The endothelium damage of COPD acute exacerbation is mainly in pulmonary capillaries.The high baseline of E-selectin,VE-cadherin and PECAM predicts that patients with COPD is prone to acute exacerbation.EMPs can be used as a susceptibility marker of COPD acute exacerbations.