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目的探讨白三烯B4(LTB4)在慢性阻塞性肺疾病(COPD)患者诱导痰和血浆的变化以及茶碱对其的影响。方法这个试验是前瞻性随机对照非盲法研究。40例COPD稳定期患者(C组),随机分为CA组(口服茶碱0·2g/次,每天2次,1个月)与CB组(不用任何茶碱类药物)。15名健康非吸烟者为正常对照组(H组)。评定各组基线水平以及C组随访1个月后的临床症状与生活质量评分,测定肺功能指标、诱导痰细胞计数与分类,并用酶联免疫吸附测定(ELISA)与酶免疫试验(EIA)方法分别测定诱导痰和血浆白细胞介素8(IL-8)与LTB4浓度。结果(1)C组诱导痰及血浆的LTB4水平分别为(794±305)pg/mg·pro、(5219±1185)ng/L,均显著高于H组[(155±64)pg/mg·pro、(2283±489)ng/L,P均<0·05]。(2)诱导痰的LTB4水平与中性粒细胞、IL-8水平呈显著正相关(r分别为0·453、0·364,P均<0·05)。(3)CA组在茶碱治疗前、后诱导痰LTB4水平分别为(812±592)、(657±459)pg/mg·pro,血浆水平为(5422±935)、(4589±1057)ng/L;CB组试验前、后诱导痰LTB4水平分别为(776±227)、(860±194)pg/mg·pro,血浆水平为(5074±1850)、(6063±2450)ng/L;这两组治疗前、后比较差异均无统计学意义(P均>0·05)。结论COPD患者LTB4水平增高,参与气道炎症过程。茶碱的治疗不能显著降低诱导痰与血浆的LTB4水平。
Objective To investigate the changes of induced sputum and plasma of leukotriene B4 (LTB4) in patients with chronic obstructive pulmonary disease (COPD) and the influence of theophylline on it. Methods This trial is a prospective, randomized, controlled, non-blinded study. Forty patients with stable COPD (group C) were randomly divided into CA group (oral 0.2 g / time, twice daily, 1 month) and CB group (without any theophylline). Fifteen healthy non-smokers were normal control group (H group). The baseline levels of each group and the clinical symptoms and quality of life scores one month after follow-up in group C were measured. Pulmonary function indexes and sputum cell counts and classification were determined. ELISA and enzyme-linked immunosorbent assay (EIA) The concentrations of induced sputum and plasma interleukin-8 (IL-8) and LTB4 were measured respectively. Results (1) The levels of LTB4 in induced sputum and plasma in group C were (794 ± 305) pg / mg · pro and (5219 ± 1185) ng / L, respectively, significantly higher than those in group H [(155 ± 64) pg / mg · Pro, (2283 ± 489) ng / L, all P <0.05]. (2) There was a significant positive correlation between LTB4 level induced by sputum and neutrophil and IL-8 levels (r = 0.453,0.364, P <0.05). (3) The levels of LTB4 in CA group before and after theophylline treatment were (812 ± 592) and (657 ± 459) pg / mg · pro respectively and the plasma levels were (5422 ± 935) and (4589 ± 1057) ng / L; The levels of LTB4 in induced sputum of CB group were (776 ± 227) and (860 ± 194) pg / mg · pro respectively before and after CB group, and were 5074 ± 1850 and 6063 ± 2450 ng / There was no significant difference between the two groups before and after treatment (P> 0.05). Conclusion The level of LTB4 in COPD patients is increased, which is involved in airway inflammation. Theophylline treatment did not significantly reduce LTB4 levels in induced sputum and plasma.