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目的:①通过测定慢性阻塞性肺疾病(COPD)患者和正常对照组尿中8-异前列腺素F2а的水平,探讨COPD患者中氧化应激的水平。②通过分析尿中8-异前列腺素F2а与动脉血气分析的各项值(氧分压,二氧化碳分压)的关系,确定氧化应激与COPD患者低氧及二氧化碳潴留的相关性。方法:22例急性加重期和稳定期的COPD患者、20例吸烟对照和20例不吸烟对照,COPD急性加重期和稳定期、正常对照组分别留取12小时尿液,并取6ml冻存,尿中8-异前列腺素F2а的测定采用酶分析法(EIA),尿中肌酐采用苦味酸法测定,血气分析用GEM3000血气分析仪测定。结果:①COPD急性加重期尿中8-异前列腺素F2а的浓度(166.17±94.68ng/mmol)明显高于稳定期(95.24±49.65ng/mmol),结果差异有统计学意义(P<0.01)。②吸烟对照组尿中8-异前列腺素F2а的浓度(121.07±51.88ng/mmol)高于不吸烟对照组(36.55±20.28ng/mmol)的浓度,结果差异有统计学意义(P<0.01)。③COPD急性加重期尿中8-异前列腺素F2а(166.17±94.68ng/mmol)与稳定期(95.24±49.65ng/mmol)的浓度明显高于不吸烟对照组(36.55±20.28ng/mmol),结果差异有统计学意义(P<0.01)。④COPD急性加重期患者尿中8-异前列腺素F2а的浓度与动脉氧分压存在显著负相关性,与二氧化碳分压存在显著正相关性(r分别为-0.442和0.658,P值分别为0.042和0.001)。结论:在急性加重期、稳定期的COPD患者和健康吸烟者,存在氧化应激水平的明显升高,急性加重期氧化应激水平要比稳定期、健康吸烟者明显升高。COPD急性加重期患者中氧化应激负荷可能与低氧血症、二氧化碳潴留有关。
OBJECTIVE: To investigate the level of oxidative stress in COPD patients by measuring the level of 8-iso-prostaglandin F2α in patients with chronic obstructive pulmonary disease (COPD) and normal control group. ② The relationship between oxidative stress and hypoxia and carbon dioxide retention in patients with COPD was determined by analyzing the relationship between urinary 8-iso-prostaglandin F2а and arterial blood gas analysis (oxygen partial pressure, partial pressure of carbon dioxide). Methods: Twenty-two COPD patients with acute exacerbation and stable phase, 20 patients with smoking control and 20 non-smoking controls, acute exacerbation and stable COPD were enrolled in this study. Determination of urinary 8-iso-prostaglandin F2а enzyme assay (EIA), urine creatinine measured by picric acid method, blood gas analysis with GEM3000 blood gas analyzer. Results: ① The urinary concentration of 8-iso-prostaglandin F2а in patients with acute exacerbation of COPD (166.17 ± 94.68ng / mmol) was significantly higher than that of the stable patients (95.24 ± 49.65ng / mmol). The difference was statistically significant (P <0.01). ② The concentration of 8-iso-prostaglandin F2а in the smoking control group (121.07 ± 51.88ng / mmol) was higher than that in the non-smoking control group (36.55 ± 20.28ng / mmol), the difference was statistically significant (P0.01) . ③ The concentration of 8-iso-prostaglandin F2а (166.17 ± 94.68ng / mmol) and stable period (95.24 ± 49.65ng / mmol) in urine of patients with COPD exacerbation was significantly higher than that of non-smoking control (36.55 ± 20.28ng / mmol) The difference was statistically significant (P <0.01). ④ In patients with acute exacerbation of COPD, there was a significant negative correlation between the concentration of 8-iso-prostaglandin F2α and arterial oxygen pressure (P <0.05) 0.001). CONCLUSIONS: In acute exacerbation, stable COPD patients and healthy smokers, there is a significant increase in oxidative stress levels, acute exacerbations of oxidative stress than stable, healthy smokers were significantly higher. Oxidative stress in patients with acute exacerbation of COPD may be related to hypoxemia and carbon dioxide retention.