Comparative Study of Neutrophil Elastase and Total Antioxidant Capacity in Serum of COPD Patients with Different HRCT Phenotypes
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摘要:
目的 探讨中性粒细胞弹性蛋白酶（neutrophil elastase，NE）、总抗氧化能力（total antioxidative capability，T-AOC）在慢性阻塞性肺疾病（chronic obstructive pulmonary disease，COPD）高分辨率CT（high-resolution computed tomography，HRCT）不同表型中的差异。 方法 对78例门诊COPD患者，采用HRCT将COPD患者分为A表型、M表型和E表型，分别测定三组患者NE及T-AOC。 结果 COPD患者M表型的血清NE含量高于对照组、A表型、E表型（P < 0.05）；E表型的血清NE含量高于对照组、A表型（ P < 0.05）；三组及对照组T-AOC差异无统计学意义（ P > 0.05）；血清NE与FEV1、FEV1%pred呈负相关（ P < 0.05），与CAT评分呈正相关（ P < 0.05）。 结论 NE在COPD患者不同HRCT表型中的表达上调并与肺功能指标相关，NE可能参与了COPD的气道炎症、气道重构过程，并引起气流阻塞。 -
关键词:
- COPD /
- 表型 /
- HRCT /
- 血清中性粒细胞弹性蛋白酶 /
- 总抗氧化能力
Abstract:Objective To explore the neutrophil elastase（neutrophil elastase, NE）, total antioxidant capacity（total antioxidative capability, T - AOC）in chronic obstructive pulmonary disease（chronic obstructive pulmonary diseases, COPD）high-resolution CT（high-resolution computed tomography, HRCT）in different HRCT phenotypes. Methods HRCT was used for typing 78 patients with out-patient COPD into phenotype A, phenotype M and phenotype E; NE and T-AOC of the three groups of patients were tested. Results The serum NE concentration of phenotype M in COPD patients was higher than that of control group, phenotype A and phenotype E（P < 0.05）. The serum NE concentration of phenotype E was higher than that of control group and phenotype A（ P < 0.05）. There was no significant difference in T-AOC between the three groups and the control group（ P > 0.05）. The NE in serum was negatively correlated with FEV1 and FEV1% pred.（ P < 0.05）, and positively correlated with CAT score（ P < 0.05）. Conclusion The expression of NE in COPD patients with different HRCT phenotypes is up-regulated and correlated with lung function indicators, and NE may be involved in airway inflammation and airway remodeling in COPD and cause airflow obstruction. -
表 1 研究对象的一般临床资料[（
$\bar x \pm s$ ）/n（%）]Table 1. General information of the subjects[（
$\bar x \pm s$ ）/n（%）]资料 对照组（n = 20） E表型（n = 33） M表型（n = 21） A表型（n = 24） 年龄（岁） 68.10 ± 1.5 68.97 ± 1.2 68.68 ± 1.6 68.33 ± 1.9 男 16（80） 27（81.8） 17（80.9） 19（79.2） 女 4（20） 6（18.2） 4（19.1） 5（20.8） 吸烟者 14（70） 23（69.7） 15（71.4） 17（70.8） FEV1实测值（L） 0.93 ± 0.6 0.77 ± 0.3∆ 1.34 ± 0.4*# FEV1/FVC% 54.12 ± 1.3 52.61 ± 1.6 59.64 ± 1.8*# FEV1%pre 46.23 ± 2.1 41.56 ± 2.2∆ 53.00 ± 1.8*# CAT评分（分） 12.65 ± 3.3 15.57 ± 2.1∆ 12.45 ± 3.5# 与E表型比较，*P < 0.05；与M表型比较， #P < 0.05；与E表型比较， ∆P < 0.05。 
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表 2 各组别血清NE、T-AOC测量值（
$\bar x \pm s$ ）Table 2. Serum NE and T-AOC data in each group（
$\bar x \pm s$ ）组别 NE（ng/mL） T-AOC（U/mL） 对照组 140.3 ± 34.3 2.9 ± 1.1 A表型 134.3 ± 49.3 2.7 ± 1.8 E表型 176.1 ± 37.4*# 3.0 ± 1.2 M表型 196.8 ± 56.0*#∆ 2.8 ± 1.5 注：与A表型比较，*P < 0.05；与对照组比较， #P < 0.05；与E表型比较， ∆P < 0.05。
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表 3 血清NE、T-AOC相关性分析
Table 3. Correlation analysis of serum NE and T-AOC
各项指标 r/P NE T-AOC FEV1 r −0.433 0.053 P 0.019* 0.786 FEV1/Pred% r −0.403 0.112 P 0.030* 0.562 CAT r 0.491 −0.069 P 3.564E-9* 0.610
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