大气颗粒物及多环芳烃暴露与慢性阻塞性肺疾病患者全身性氧化应激水平

发布时间：2018-05-19 19:24

  本文选题：空气污染 + 颗粒物　； 参考：《北京大学学报(医学版)》2017年03期

【摘要】：目的:研究环境大气颗粒物及多环芳烃(polycyclic aromatic hydrocarbons,PAHs)暴露对慢性阻塞性肺疾病(chronic obstructive pulmonary disease,COPD)患者全身性氧化应激水平的影响。方法:招募45名居住在北京大学医学部半径5 km范围内的COPD患者作为研究对象,采用定组研究方法,于2014年11月至2015年5月对研究对象进行两次临床随访。通过肺功能检查测定第1秒用力呼气容积占预计值百分比(即FEV1%预计值),用于评估COPD患者病情的严重程度。收集患者尿样,分别采用高效液相色谱(high performance liquid chromatography,HPLC)法和酶联免疫吸附测定(enzyme-linked immunosorbent assay,ELISA)法测定尿样中的全身性氧化应激指标丙二醛(malondialdehyde,MDA)和8-羟基脱氧鸟苷(8-hydroxy-2'-deoxyguanosine,8-OHd G)水平,同时,通过本课题组于校园内自行建立的空气污染监测站点连续收集研究期间该区域的环境大气污染物浓度以获得人群污染物暴露水平。利用线性混合效应模型,分别通过单污染物模型、双污染物模型和分层分析来研究大气污染物对COPD患者尿样中MDA和8-OHd G水平的影响。结果:滞后2 d(lag2)的超细颗粒物(ultrafine particles,UFP)和PAHs浓度与尿样中MDA水平呈显著正相关(P0.05),UFP和PAHs每升高四分位间距(interquartile range,IQR)浓度,MDA浓度分别升高28%(95%CI:4%~57%)和36%(95%CI:4%~77%),控制黑碳(black carbon,BC)的影响后,UFP和PAHs与MDA的关联强度略有升高。以COPD的严重程度进行分层分析后发现,多数污染物在疾病程度较轻的COPD患者中具有更强的氧化应激效应。在FEV1%预计值≥50%的COPD患者中发现,UFP每升高IQR浓度,尿样中MDA浓度升高98%(95%CI:38%~186%),BC、UFP和PAHs每升高IQR浓度,尿样中8-OHd G浓度分别升高87%(95%CI:32%~166%)、69%(95%CI:24%~130%)和156%(95%CI:66%~294%)。本研究未观察到细颗粒物(fine particulate matter,PM_(2.5))与尿样中氧化应激指标的显著关联。结论:大气污染物暴露可加重COPD患者全身性氧化应激水平,其中UFP和PAHs的效应更为显著,并且污染物对于疾病程度较轻的COPD患者氧化应激效应更强。
[Abstract]:Aim: to study the effects of environmental atmospheric particulates and polycyclic aromatic hydrocarbonization (PAHs) on systemic oxidative stress in patients with chronic obstructive pulmonary disease (COPD). Methods: 45 COPD patients living within 5 km radius of Peking University Department of Medicine were recruited as study subjects. The subjects were followed up twice from November 2014 to May 2015. The forced expiratory volume in the first second (FEV 1%) was measured by pulmonary function test to evaluate the severity of COPD patients. Urine samples were collected and the levels of malondialdehyde (MDA) and 8-hydroxy-2deoxyguanosine 8-OHd (8-hydroxy-2deoxyguanosine) were determined by high performance liquid chromatography (HPLC) and enzyme-linked immunosorbent assayanosa (Elisa). The concentration of atmospheric pollutants in the area was collected continuously by the air pollution monitoring station set up by our group in order to obtain the exposure level of pollutants in the population. The effects of atmospheric pollutants on the levels of MDA and 8-OHd G in urine samples of COPD patients were studied by single pollutant model, double pollutant model and stratified analysis using linear mixed effect model. Results: the concentrations of ultrafine particles (UFPV) and PAHs in urine were significantly positively correlated with the levels of MDA in urine samples. The concentrations of UFP and PAHs increased 2895CI45757) and 3695% CI: 477%, respectively, in order to control the effects of black carbon (UFP) and PAHs. The correlation strength with MDA increased slightly. By stratified analysis of the severity of COPD, it was found that most pollutants had stronger oxidative stress effects in patients with mild COPD. In patients with COPD with FEV1% predicted value 鈮，

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