甲型流感病毒感染致AECOPD的氧化应激机制研究

发布时间：2019-02-19 18:39

【摘要】：目的：研究甲型流感病毒感染对慢性阻塞性肺疾病急性加重(Acute Exacerbation of Chronic Obstructive Pulmonary Disease AECOPD)患者氧化应激和炎症反应的影响,并研究乙酰半胱氨酸对慢性阻塞性肺疾病急性加重的预防作用。方法：第一部分：选取152例AECOPD患者,用RT-PCR方法检测病人痰液中RNA病毒,流感病毒阳性患者42例(流感组),阴性者110例(对照组),比较两组患者诱导痰中丙二醛(MDA)、超氧化物岐化酶(SOD)、非酶性抗氧化剂微量还原型谷胱甘肽(GSH)水平及血浆中IL-6、IL-8水平,分析流感病毒表达与氧化应激指标、炎症指标的相关性。第二部分：将检出的流感病毒阳性的42例病人病情好转出院后,继续服用乙酰半胱氨酸者(治疗组)23例,未继续用药者(对照组)19例,跟踪随访3个月,随访结束时测定诱导痰中SOD、MDA水平、及血浆炎症因子(IL-6、IL-8)水平并比较两组患者呼吸困难评分(MRC和BDI)、急性发作的次数。结果：第一部分：流感病毒感染患者42例。流感组诱导痰中MDA水平高于对照组,对照组诱导痰中SOD、GSH水平高于流感组,组间差别有统计学意义。流感组血浆IL-6和IL-8水平均高于对照组(P0.05)。流感组内,流感病毒表达强度与痰标本中MDA水平正相关(r=0.557,P0.05),而痰标本中MDA与血浆IL-8水平正相关(r=0.463,P0.05)。第二部分：治疗后,治疗组SOD水平明显高于对照组,MDA、IL-8水平明显低于对照组,治疗组BDI高于对照组(p0.05),而两组MRC评分无统计学差异。并且治疗组急性发作的次数明显低于对照组,差异均有统计学意义,P0.05。结论：第一部分：甲型流感病毒感染引起的慢性阻塞性肺疾病急性加重患者气道氧化应激状态增强和全身炎症增强。笫二部分：乙酰半胱氨酸可以调节机体的氧化与抗氧化失衡,长期服用可以降低AECOPD发作的次数。
[Abstract]:Objective: to study the effect of influenza A virus infection on oxidative stress and inflammatory response in patients with acute exacerbation of chronic obstructive pulmonary disease (Acute Exacerbation of Chronic Obstructive Pulmonary Disease AECOPD). To study the preventive effect of acetylcysteine on acute exacerbation of chronic obstructive pulmonary disease (COPD). Methods: the first part: select 152 patients with AECOPD, detect RNA virus in sputum by RT-PCR method, 42 cases of influenza virus positive patients (influenza group), 110 cases of negative cases (control group), compare the malondialdehyde (MDA), in induced sputum between the two groups. The levels of reduced glutathione (GSH) (GSH) and IL-6,IL-8 in plasma were determined by superoxide dismutase (SOD),) non-enzymatic antioxidant. The correlation between influenza virus expression and oxidative stress index and inflammation index was analyzed. The second part: 42 patients with positive influenza virus were treated with acetylcysteine (treatment group) and 19 patients (control group), and were followed up for 3 months. At the end of follow-up, the levels of SOD,MDA in induced sputum and plasma inflammatory factor (IL-6,IL-8) were measured and the respiratory dyspnea scores (MRC and BDI),) were compared between the two groups. Results: the first part: 42 cases of influenza virus infection. The level of MDA in induced sputum in influenza group was higher than that in control group, and the level of SOD,GSH in induced sputum in control group was higher than that in influenza group. The levels of plasma IL-6 and IL-8 in influenza group were higher than those in control group (P0.05). In the influenza group, the expression intensity of influenza virus was positively correlated with the level of MDA in sputum (r: 0.557 P 0.05), while the level of MDA in sputum was positively correlated with the level of plasma IL-8 (P 0.05). The second part: after treatment, the level of SOD in the treatment group was significantly higher than that in the control group, and the level of MDA,IL-8 in the treatment group was significantly lower than that in the control group. The BDI in the treatment group was higher than that in the control group (p0.05), but there was no significant difference in MRC score between the two groups. And the number of acute attack in the treatment group was significantly lower than that in the control group, the difference was statistically significant (P 0.05). Conclusion: the first part is the enhancement of airway oxidative stress and systemic inflammation in patients with acute exacerbation of chronic obstructive pulmonary disease caused by influenza A virus infection. Part two: acetylcysteine can regulate the imbalance of oxidation and anti-oxidation, long-term administration can reduce the number of AECOPD attacks.
【学位授予单位】：青岛大学
【学位级别】：硕士
【学位授予年份】：2013
【分类号】：R563.9

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