CAJ | 학술논문

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。
목적：탐토만성조새성폐질병（COPD）환자체내포질형린지매A2α（cPLA2α）화일양화담（NO）적변화급의의。방법선취천진중의약대학부속무청중의원중증의학과수치적COPD환자100례，안조COPD엄중정도분급표준분위경도조25례，중도조25례，중도조26례，겁중도조24례，이동기90례폐공능정상적건강체검자위건강대조조。용매련면역흡부시험（ELISA）검측수시자cPLA2α수평；용매법검측각조수시자혈뇨산（UA）、총담고순（TC）급삼선감유（TG）수평；용초산환원매법측정혈청NO대사산물초산염화아초산염（NOx）。결과여건강대조조비교，불동엄중정도COPD각조혈청cPLA2α화혈UA수평균현저승고；수착COPD분급엄중정도가중，COPD경、중、중、겁중도조환자cPLA2α、UA수평축점승고、NOx수평축점하강〔cPLA2α（ng/L）：125.60±8.17、155.20±6.42、190.20±9.32、255.80±11.28비88.50±7.99，UA（μmol/L）：381.23±32.22、434.95±87.71、464.81±52.65、487.45±82.61비241.95±52.33，NOx（μmol/L）：59.90±17.52、45.60±6.17、38.20±4.08、25.70±3.04비74.90±18.31，균P＜0.05〕。불동엄중정도COPD각조간혈cPLA2α화혈청NOx수평차이균유통계학의의（P＜0.05）。각조TC、TG수평비교차이균무통계학의의（균P＞0.05）。cPLA2α화NOx수평정현저부상관（rs＝-0.798，P＝0.013）。결론연합검측혈중cPLA2α화NOx가진단COPD엄중정도，cPLA2α가이작위COPD분급적신파표。
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.