基于痰液中的黏蛋白分析研究COPD急性加重期（肺脾气虚证）的发病特点

发布时间：2018-07-21 19:17

【摘要】：目的:检测慢性阻塞性肺疾病患者与正常对照者痰液中MUC5AC、MUC5B及相关介质的含量,分析慢性阻塞性肺疾病急性加重组(肺脾气虚证)、慢性阻塞性肺疾病稳定期组(肺脾气虚证)及正常对照组中MUC5AC、MUC5B及炎症介质等指标数目的差异;揭示COPD急性加重型(肺脾气虚证)呼吸道黏液的变化状态及黏蛋白在慢性阻塞性肺疾病患者病情评估方面中的作用,说明黏蛋白的异常分泌和COPD急性加重型(肺脾气虚证)密切相关,为临床分型治疗提供参考,为阐述“脾为生痰之源,肺为贮痰之器”的中医理论提供科学的研究基础。方法:对120名慢性阻塞性肺疾病的患者及60名正常人采用诱导痰的方法,分离痰标本,并进行细胞计数及分类;对分离的痰液上清液采用酶联免疫吸附法(ELISA)检测其中的MUC5AC、MUC5B。结果:慢性阻塞性肺疾病稳定期、COPD急性加重期、正常对照组中,慢性阻塞性肺疾病患者中的MUC5AC、MUC5B增高,三组之间差异有统计学意义(P0.05),其中诱导痰在COPD急性加重期增加,慢性阻塞性肺疾病稳定期减少,COPD急性加重期与正常对照组差异有统计学意义(P0.05),COPD急性加重期与COPD稳定期差异有统计学意义(P0.05),COPD稳定期与正常对照组差异有统计学意义(P0.05)。患者在诱导痰中,中性粒细胞、淋巴细胞及嗜酸性粒细胞均高于正常对照组,三组间差异有统计学意义(P0.05)。结论:MUC5AC、MUC5B与炎症介质共同参与慢性阻塞性肺疾病的发病,黏蛋白的异常分泌与慢性阻塞性肺病关系密切,是慢性阻塞性肺病发病的物质基础,对黏蛋白的深入研究可为阐述“脾为生痰之源,肺为贮痰之器”提供科学基础。
[Abstract]:Objective: to detect the content of MUC5 ACU MUC5B and its related mediators in sputum of patients with chronic obstructive pulmonary disease (COPD) and normal controls. To analyze the difference of MUC5AC MUC5B and inflammatory mediators in acute exacerbation of chronic obstructive pulmonary disease (COPD), stable stage of COPD (deficiency of lung and spleen qi) and normal control group. To reveal the changes of respiratory mucus in acute exacerbation of COPD (deficiency of lung and spleen qi) and the role of mucin in the evaluation of chronic obstructive pulmonary disease (COPD). It is suggested that the abnormal secretion of mucin is closely related to the acute exacerbation of COPD (deficiency of lung and spleen qi), which provides a reference for clinical classification and treatment, and provides a scientific research basis for expounding the TCM theory that "spleen is the source of sputum and the lung is the organ for storing phlegm". Methods: the sputum samples were isolated from 120 patients with chronic obstructive pulmonary disease (COPD) and 60 normal controls, and the isolated sputum supernatants were detected by enzyme linked immunosorbent assay (Elisa). Results: the MUC5AC MUC5B in COPD patients was significantly higher than that in the control group (P0.05), and the induced sputum was increased in the acute exacerbation of COPD. Chronic obstructive pulmonary disease stable phase decreased COPD acute exacerbation phase and normal control group difference was statistically significant (P0.05) there was significant difference between COPD acute exacerbation stage and COPD stable phase (P0.05). There was significant difference between COPD stable phase and normal control group (P0.05). Patients in induced sputum, neutrophils, lymphocytes and eosinophil were higher than the normal control group, there was significant difference among the three groups (P0.05). Conclusion MUC5AC MUC5B and inflammatory mediators are involved in the pathogenesis of chronic obstructive pulmonary disease. The abnormal secretion of mucin is closely related to chronic obstructive pulmonary disease, and it is the material basis of the pathogenesis of chronic obstructive pulmonary disease. The further study of mucin can provide a scientific basis for explaining that the spleen is the source of sputum and the lung is the organ for storing phlegm.
【学位授予单位】：新疆医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R259

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