[慢性阻塞性肺疾病患者体内的内源性硫化氢]
[Endogenous hydrogen sulfide in patients with chronic obstructive pulmonary disease].
作者信息
Chen Ya-hong, Yao Wan-zhen, Geng Bin, Ding Yan-ling, Lu Ming, Zhao Ming-wu, Tang Chao-shu
机构信息
Department of Respiratory Medicine, Peking University Third Hospital, Beijing 100083, China.
出版信息
Zhonghua Jie He He Hu Xi Za Zhi. 2005 Oct;28(10):694-7.
OBJECTIVE
To investigate the role of endogenous hydrogen sulfide (H(2)S) in patients with chronic obstructive pulmonary disease (COPD).
METHODS
Levels of serum H(2)S and nitric oxide (NO), lung function and cell differential count in induced sputum were studied in 27 patients with acute exacerbation of COPD (AECOPD), 37 patients with stable COPD and 13 health subjects. Echo-Doppler assessment and arterial blood gas were measured in patients with AECOPD.
RESULTS
(1) The serum H(2)S level was significantly higher in patients with stable COPD [(50.8 +/- 2.5) micromol/L] as compared to those in the controls [(39.8 +/- 1.6) micromol/L] and in patients with AECOPD [(33.5 +/- 2.2) micromol/L, P < 0.01]. (2) The level of serum H(2)S was significantly lower in smokers with AECOPD [(28.1 +/- 1.3) micromol/L] as compared to nonsmokers with AECOPD [(39.4 +/- 3.9) micromol/L, P < 0.05] and healthy nonsmokers [(39.8 +/- 1.6) micromol/L, P < 0.01]. (3) There was significant difference in the serum H(2)S level among stable COPD patients with different severity of airway obstruction (P < 0.05); being lower in patients with stage III [(45.1 +/- 4.1) micromol/L] as compared to stage I obstruction [(70.2 +/- 6.2) micromol/L, P < 0.05]. (4) AECOPD with pulmonary hypertension pulmonary artery systolic pressure (PASP) > or = 35 mm Hg (1 mm Hg = 0.133 kPa) showed a lower serum H(2)S level [(26.3 +/- 2.2), (36.2 +/- 2.5) micromol/L, P < 0.05] than that with a normal resting PASP. (5) H(2)S in serum was positively correlated with NO levels (r = 0.278, P = 0.029), FEV(1)% predicted values (r = 0.533, P = 0.000), percentage of sputum lymphocytes (r = 0.286, P = 0.028) and macrophages (r = 0.334, P = 0.01); and negatively correlated with PASP (r = -0.561, P = 0.011) and the percentage of sputum neutrophils (r = -0.422, P = 0.001) in patients with COPD.
CONCLUSION
Endogenous H(2)S may be involved in the pathogenesis of airway obstruction in COPD and may be a noninvasive marker of disease activity and severity.
目的
探讨内源性硫化氢（H₂S）在慢性阻塞性肺疾病（COPD）患者中的作用。
方法
研究了27例慢性阻塞性肺疾病急性加重期（AECOPD）患者、37例稳定期COPD患者和13名健康受试者的血清H₂S和一氧化氮（NO）水平、肺功能及诱导痰细胞分类计数。对AECOPD患者进行了超声多普勒评估和动脉血气分析。
结果
（1）稳定期COPD患者血清H₂S水平[（50.8±2.5）μmol/L]显著高于对照组[（39.8±1.6）μmol/L]和AECOPD患者[（33.5±2.2）μmol/L，P<0.01]。（2）AECOPD吸烟者血清H₂S水平[（28.1±1.3）μmol/L]显著低于AECOPD非吸烟者[（39.4±3.9）μmol/L，P<0.05]和健康非吸烟者[（39.8±1.6）μmol/L，P<0.01]。（3）不同气道阻塞严重程度的稳定期COPD患者血清H₂S水平存在显著差异（P<0.05）；与Ⅰ期阻塞患者[（70.2±6.2）μmol/L]相比，Ⅲ期患者[（45.1±4.1）μmol/L]血清H₂S水平较低（P<0.05）。（4）肺动脉收缩压（PASP）≥35 mmHg（1 mmHg = 0.133 kPa）的AECOPD患者血清H₂S水平[（26.3±2.2），（36.2±2.5）μmol/L，P<0.05]低于静息PASP正常的患者。（5）COPD患者血清H₂S与NO水平（r = 0.278，P = 0.029）、FEV₁%预计值（r = 0.533，P = 0.000）、痰淋巴细胞百分比（r = 0.286，P = 0.028）和巨噬细胞百分比（r = 0.334，P = 0.01）呈正相关；与PASP（r = -0.561，P = 0.011）和痰中性粒细胞百分比（r = -0.422，P = 0.001）呈负相关。
结论
内源性H₂S可能参与COPD气道阻塞的发病机制，可能是疾病活动度和严重程度的无创标志物。
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