膈肌呼出气一氧化氮浓度、一氧化氮合酶表达水平及炎性因子水平与食管病变并慢性阻塞性肺疾病患者膈肌活动度的相关性研究

Correlations of FeNO Concentration,Expression of NOS and Levels of Inflammatory Cytokines in Diaphragm with Diaphragm Mobility in Esophageal Lesion Patients Complicated with COPD

背景目前导致慢性阻塞性肺疾病(COPD)患者膈肌活动度改变的分子机制尚不完全明确。目的探讨膈肌呼出气一氧化氮(FeNO)浓度、一氧化氮合酶(NOS)表达水平及炎性因子水平与食管病变并COPD患者膈肌活动度的相关性。方法选取2015年6月-2018年12月河北北方学院附属第一医院收治的食管病变并行开胸手术患者48例,根据术前是否合并COPD分为对照组(未合并COPD,n=26)和COPD组(合并COPD,n=22)。比较两组患者膈肌活动度、FeNO浓度、NOS[包括诱导型NOS(iNOS)、内皮型NOS(eNOS)、神经型NOS(nNOS)]mRNA及蛋白相对表达量、炎性因子[包括肿瘤坏死因子α(TNF-α)、白介素1β(IL-1β)、白介素6(IL-6)、白介素8(IL-8)]水平,膈肌FeNO浓度、NOS表达水平及炎性因子水平与食管病变并COPD患者膈肌活动度的相关性分析采用Pearson相关分析。结果(1)COPD组患者膈肌活动度小于对照组,膈肌FeNO浓度高于对照组(P<0.05)。(2)COPD组患者膈肌iNOS、eNOS mRNA及蛋白相对表达量高于对照组(P<0.05);两组患者膈肌nNOS mRNA及蛋白相对表达量比较,差异无统计学意义(P>0.05)。(3)COPD组患者膈肌TNF-α、IL-1β、IL-6、IL-8水平高于对照组(P<0.05)。(4)Pearson相关分析结果显示,膈肌FeNO浓度、iNOS mRNA相对表达量、eNOS mRNA相对表达量、iNOS蛋白相对表达量、eNOS蛋白相对表达量及膈肌TNF-α、IL-1β、IL-6、IL-8水平均与食管病变并COPD患者膈肌活动度呈负相关(P<0.05)。结论膈肌FeNO浓度、iNOS及eNOS表达水平、炎性因子水平升高与食管病变并COPD患者膈肌活动度下降有关。

Background The molecular mechanism of change of diaphragm mobility in patients with COPD is not yet clear.Objective To investigate the correlations of FeNO concentration,expression of NOS and levels of inflammatory cytokines in diaphragm with diaphragm mobility in esophageal lesion patients complicated with COPD.Methods A total of48 esophageal lesion patients undergoing thoracotomy were selected in the First Affiliated Hospital of Hebei North College from June 2015 to December 2018,and they were divided into control group(did not merge with COPD,n=26)and COPD group(merged with COPD,n=22)according to the incidence of COPD before surgery.Diaphragm mobility,FeNO concentration,mRNA and protein relative expression quantity of NOS(including iNOS,eNOS,nNOS),as well as levels of inflammatory cytokines(including TNF-α,IL-1β,IL-6 and IL-8)in diaphragm were compared between the two groups;correlations of FeNO concentration,expression of NOS and levels of inflammatory cytokines in diaphragm with diaphragm mobility in esophageal lesion patients complicated with COPD were analyzed by Pearson correlation analysis.Results(1)Diaphragm mobility in COPD group was statistically significantly smaller than that in control group,while FeNO concentration in diaphragm in COPD group was statistically significantly higher than that in control group(P<0.05).(2)mRNA and protein relative expression quantity of iNOS and eNOS in diaphragm in COPD group was statistically significantly higher than that in control group,respectively(P<0.05),while no statistically significant difference of mRNA or protein relative expression quantity of nNOS was found between the two groups(P>0.05).(3)Levels of TNF-α,IL-1β,IL-6 and IL-8 in diaphragm in COPD group were statistically significantly higher than those in control group(P<0.05).(4)Pearson correlation analysis results showed that,FeNO concentration,mRNA and protein relative expression quantity of iNOS,mRNA and protein relative expression quantity of eNOS as well as levels of TNF-α,IL-1β,IL-6 and IL-8 in diaphragm were negatively correlated with the diaphragm mobility in esophageal lesion patients complicated with COPD(P<0.05).Conclusion Elevation of FeNO concentration,expressions of iNOS and eNOS,as well as levels of TNF-α,IL-1β,IL-6 and IL-8 in diaphragm is significantly correlated with the decrease of diaphragm mobility in esophageal lesion patients complicated with COPD,respectively.