血浆膜微粒水平与慢性阻塞性肺疾病的相关性研究

Clinical research of correlation between circulating microparticles level and chronic obstructive pulmonary disease

目的对慢性阻塞性肺疾病患者循环中细胞膜微粒的水平与肺功能进行检测,并探讨其相关性。方法选取2014年6月-2015年6月在本院门诊及住院治疗的慢阻肺患者106例,包括稳定期患者和急性加重期患者各53例,并选取同期的健康体检者53例为对照组;流式细胞仪检测各组患者和53例健康志愿者血浆膜微粒水平,包括内皮细胞膜微粒(EMP)、血小板膜微粒(PMP)、组织因子阳性膜微粒(TF+MP),并记录肺功能情况,探讨膜微粒水平与慢阻肺肺功能变化的相关性。结果 3组血浆EMP和PMP水平比较,差异有统计学意义(P<0.01),其中慢阻肺稳定期组的EMP和PMP水平显著低于AECOPD组,差异有统计学意义(P<0.05)。对照组的EMP和PMP水平显著低于稳定期和急性加重期患者,差异有统计学意义(P<0.05);各组血浆TF+MP水平差异无统计学意义。慢阻肺患者EMP水平与肺功能中的FEV_1、FEV_1/FVC均呈负相关(P<0.01);PMP水平与肺功能中的FEV_1、FEV_1/FVC均呈负相关(P<0.01);TF+MP水平与肺功能中的FEV_1、FEV_1/FVC无明显相关性。结论内皮细胞膜微粒、血小板膜微粒水平变化与慢阻肺及其急性加重过程密切相关,可作为其诊断和疾病进展的生物学标志物之一。

Objective To investigate the correlation between the changes of cell membrane microparticles and chronic obstructive pulmonary disease. Methods 106 COPD patients were collected from June 2014 to June 2015, including 53 cases at stable stage and 53 cases at acute exacerbation in patients with 53 cases in each group, and another 53 healthy people were taken as the control group. Their plasma membranes particulate level, including TF~ MP endothelial microparticles （EMP）, platelet membrane microparticles （PMPs）, and tissue factor positive membrane particles were detected by flow cytometry, and their lung function was observed. The correlation between membrane micropartieles and pulmonary function changes was analyzed. Results There were significant differences in plasma EMP and PMP levels among the 3 groups （P 〈 0. 01 ）. The levels of EMP and PMP were significantly lower in the COPD group than in the AECOPD group （ P 〈 0. 05 ）, and they significantly lower in the control group than in the COPD group and the AECOPD group （ P 〈 0. 05 ）. There was no significant difference in plasma TF＋ MP level among the three groups. FEV1 and FEV1/FVC of lung function and EMP showed a negative correlation in COPD patients （P 〈 0. 01 ）. PMP level and FEV1 and FEV1/FVC showed a negative correlation （P 〈 0. 01 ）. TF＋ MP level and lung function had no significant correlation. Conclusion The changes of endothelial membrane micropartieles and platelet membrane particles are closely related to the COPD and acute exacerbation, and it can be used as one of the biomarkers for diagnosis and disease progression.