褪黑素对稳定期中重度慢性阻塞性肺疾病患者氧化应激和炎症反应的影响

发布时间：2018-05-31 20:32

本文选题：褪黑素 + 慢性阻塞性肺病　；参考：《实用医学杂志》2017年15期

【摘要】：目的探讨褪黑素治疗对稳定期中重度慢性阻塞性肺疾病(COPD)患者氧化应激和炎症反应的影响并探讨其机制。方法 42例稳定期中重度COPD患者分为褪黑素组和安慰剂组,每组各21例,分别接受褪黑素(3 mg/d)或安慰剂治疗,持续3个月。对比分析患者在治疗前及治疗后2、3个月3个时间点血浆中8-异前列腺素、白细胞介素-8(IL-8)、肿瘤坏死因子α(TNF-α)和超敏C反应蛋白(h-CRP)的浓度、肺功能、6 min步行实验和MRC呼吸困难评分。结果治疗2个月后,褪黑素组血浆中的8-异前列腺素较安慰剂组显著降低(10.40±5.4 vs.16.92±4.33,P0.05),IL-8较安慰剂组显著降低(6.88±2.37 vs.11.33±3.39,P0.05)。治疗3个月后,褪黑素组血浆中8-异前列腺素、IL-8的浓度较安慰剂组显著降低,分别为(9.40±4.0 vs.17.92±3.33,P0.01)、(5.67±3.22 vs.9.31±3.23,P0.05);褪黑素组患者血浆中8-异前列腺素、IL-8的浓度较治疗前显著降低,分别为(9.40±4.0 vs.20.40±8.4,P0.01)、(5.67±3.22vs.12.33±3.88,P0.05)。褪黑素组患者TNF-α浓度、h-CRP浓度较安慰剂组显著降低,分别为(25.83±9.18 vs.35.83±12.18,P0.05)、(1.76±1.18 vs.3.09±1.79,P0.05)。3个月后,褪黑素组患者呼吸困难评分较安慰剂组显著改善(1.56±1.38 vs.2.09±1.16,P0.05),两组患者在肺功能和6 min步行实验结果无统计学差异。结论褪黑素降低稳定期COPD患者血液中的8-异前列腺素、IL-8、TNF-α和h-CRP的浓度,改善患者呼吸困难评分。褪黑素对稳定期中重度COPD患者在降低氧化应激和抑制炎症反应上作用显著,显示其对COPD具有潜在的治疗价值。
[Abstract]:Objective to investigate the effects of melatonin therapy on oxidative stress and inflammatory response in patients with moderate and severe chronic obstructive pulmonary disease (COPD) and to explore its mechanism. Methods Forty-two patients with moderate and severe COPD were divided into two groups: melatonin group (n = 21) and placebo group (n = 21). Each group received melatonin 3 mg / d or placebo for 3 months. The plasma levels of 8-isoprostaglandin, interleukin-8 IL-8, tumor necrosis factor 伪 -TNF- 伪, hypersensitive C-reactive protein hCRP), pulmonary function 6 min walking test and MRC dyspnea score were compared and analyzed before and 2, 3 months after treatment. Results after 2 months of treatment, the plasma levels of 8-isoprostaglandin in melatonin group were significantly lower than those in placebo group (10.40 卤5.4 vs.16.92 卤4.33 vs.16.92 卤0.05 vs.16.92) and 6.88 卤2.37 vs.11.33 卤3.39 vs.11.33 respectively. After 3 months of treatment, the plasma concentration of 8-isoprostaglandin IL-8 in melatonin group was significantly lower than that in the placebo group (9.40 卤4.0 vs.17.92 卤3.33 vs.9.31 卤3.23 vs.9.31 卤0.05 vs.9.31, respectively), and the plasma concentration of 8-isoprostaglandin IL-8 in melatonin group was significantly lower than that in the control group (9.40 卤4.0 vs.20.40 卤8.4 vs.20.40 卤8.84 vs.20.40 卤3.88P0.05, respectively). The concentration of TNF- 伪 and h-CRP in melatonin group was significantly lower than that in placebo group (25.83 卤9.18 vs.35.83 卤12.18 vs.35.83 卤0.05 vs.35.83 卤1.76 卤1.18 vs.3.09 卤1.79 vs.3.09 卤0.05 渭 g / L), respectively. 3 months later, the concentration of TNF- 伪 in melatonin group was significantly lower than that in placebo group. The score of dyspnea in melatonin group was significantly better than that in placebo group (1.56 卤1.38 vs.2.09 卤1.16 P0.05). There was no significant difference in pulmonary function and 6 min walking test between the two groups. Conclusion melatonin can decrease the concentration of 8-isoprostaglandin IL-8 TNF- 伪 and h-CRP in the blood of patients with stable COPD and improve the score of dyspnea. Melatonin plays a significant role in reducing oxidative stress and inhibiting inflammatory response in patients with moderate and severe COPD, indicating that melatonin has potential therapeutic value for COPD.
【作者单位】：华中科技大学同济医学院附属武汉中心医院呼吸内科;
【基金】：武汉市卫计委课题(编号:WX14A03)
【分类号】：R563.9

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