CAJ | 학술논문

目的探讨慢性阻塞性肺疾病(COPD)急性加重(AECOPD)患者凝血功能异常与氧化应激的关系.方法选28例AECOPD患者和30例健康对照者,检测其血浆中组织因子(TF)、组织因子途径抑制剂(TFPI)活性、总抗氧化能力(TAC)、丙二醛(MDA)、谷胱甘肽过氧化物酶(GSH-PX)活性及肺功能,并行动脉血气分析.结果 (1)与治疗前比较,AECOPD患者治疗后血浆TF、TFPI、TF/TFPI水平均明显下降(P<0.01),但仍高于健康对照者(P<0.01).(2)与治疗前比较,AECOPD患者治疗后血浆TAC、GSH-PX水平虽升高,但仍低于健康对照者;治疗后血浆MDA水平下降,但仍高于健康对照者(P<0.05).(3)相关分析:AECOPD患者治疗前TF/TFPI与血浆TAC、GSH-PX、PaO2呈负相关(r分别为-0.518、-0.454、-0.511;P<0.01,P<0.05,P<0.01),与中性粒细胞百分比呈正相关(r=0.379,P<0.05);而AECOPD患者治疗后TF/TFPI与血浆TAC、第1秒用力呼气容积占预计值百分比呈负相关(r分别为-0.420、-0.480;P值均小于0.05),与血浆MDA呈正相关(r=0.451,P<0.05).结论 AECOPD患者存在凝血/抗凝失衡及氧化/抗氧化失衡,凝血/抗凝失衡与氧化/抗氧化失衡之间存在显著相关性.
목적 탐토만성조새성폐질병(COPD)급성가중(AECOPD)환자응혈공능이상여양화응격적관계.방법 선28례AECOPD환자화30례건강대조자,검측기혈장중조직인자(TF)、조직인자도경억제제(TFPI)활성、총항양화능력(TAC)、병이철(MDA)、곡광감태과양화물매(GSH-PX)활성급폐공능,병행동맥혈기분석.결과 (1)여치료전비교,AECOPD환자치료후혈장TF、TFPI、TF/TFPI수평균명현하강(P<0.01),단잉고우건강대조자(P<0.01).(2)여치료전비교,AECOPD환자치료후혈장TAC、GSH-PX수평수승고,단잉저우건강대조자;치료후혈장MDA수평하강,단잉고우건강대조자(P<0.05).(3)상관분석:AECOPD환자치료전TF/TFPI여혈장TAC、GSH-PX、PaO2정부상관(r분별위-0.518、-0.454、-0.511;P<0.01,P<0.05,P<0.01),여중성립세포백분비정정상관(r=0.379,P<0.05);이AECOPD환자치료후TF/TFPI여혈장TAC、제1초용력호기용적점예계치백분비정부상관(r분별위-0.420、-0.480;P치균소우0.05),여혈장MDA정정상관(r=0.451,P<0.05).결론 AECOPD환자존재응혈/항응실형급양화/항양화실형,응혈/항응실형여양화/항양화실형지간존재현저상관성.
Objective To explore the relationship between coagulation/anticoagulation imbalance and oxidative stress in the patients with chronic obstructive pulmonary disease during acute exacerbation (AECOPD)before and after treatment.Methods Plasma tissue factor(TF)and tissue factor pathway inhibitor(TFPl)activity was detected by chromogenic assay in 28 AECOPD patients before and after treatment as well as in 30 healthy controls.The total antioxidative capacity(TAC),malondialdehyde (MDA)and gtutathione peroxidase(GSH-PX)in plasma were measured in both groups.Results The levels of plasma TF and TFPI,and their ratio(TF/TFPI)in AECOPD patients before treatment were significantly higher than those after treatment(all P<0.0 1),the latter were still higher than those in the healthy persons(all P<0.01).The levels of the TAC and GSH-PX in plasma in AECOPD patients before treatment were significantly lower than those after treatment(all P<0.01),the latter were still lower than those in the healthy persons(all P<0.01).The plasma MDA in AECOPD patients before treatment was significantly higher than that after treatment(P<0.0 1),which was still higher than that in the healthy persons(P<0.05).There were negative correlations between TF/TFPI ratio and TAC(r=-0.518.P<0.01),GSH-PX(r=-0.454,P<0.05),PaO2(r=-0.511,P<0.01)respectively and a positive correlation between TF/TFPI ratio and the percentage of neutrophils(r=0.379,P<0.05)in AECOPD patients before treatment.There still were negative correlations between TF/TFPI ratio and TAC (r=-0.420,P<0.05),FEV1% to predicted(r=-0.480,P<0.05)respectively,and a positive correlation between TF/TFPI ratio and MDA(r=0.45 1,P<0.05)in AECOPD patients after treatment.Conclusions There existed coagulation/anticoagulation imbalance and oxidation/antioxidation imbalance before and after treatment in AECOPD patients and their relationship was explored.