[慢性阻塞性肺疾病患者凝血/抗凝失衡与氧化应激的关系]

[The relationship between coagulation/anticoagulation imbalance and oxidative stress in patients with chronic obstructive pulmonary disease].

作者信息

Huang Jin, Liu Xiao-ju, Bao Hai-rong, Zhang Yi, Tan En-li, Liao Jian-min

机构信息

Department of Gerontal Respiratory Medicine, the First Hospital of Lanzhou University, Lanzhou 730000, China.

出版信息

Zhonghua Nei Ke Za Zhi. 2011 Aug;50(8):664-7.

PMID:22093558

Abstract

OBJECTIVE

To explore the relationship between coagulation/anticoagulation imbalance and oxidative stress in the patients with chronic obstructive pulmonary disease during acute exacerbation (AECOPD) before and after treatment.

METHODS

Plasma tissue factor (TF) and tissue factor pathway inhibitor (TFPI) activity was detected by chromogenic assay in 28 AECOPD patients before and after treatment as well as in 30 healthy controls. The total antioxidative capacity (TAC), malondialdehyde (MDA) and glutathione peroxidase (GSH-PX) in plasma were measured in both groups.

RESULTS

The levels of plasma TF and TFPI, and their ratio (TF/TFPI) in AECOPD patients before treatment were significantly higher than those after treatment (all P < 0.01), the latter were still higher than those in the healthy persons (all P < 0.01). The levels of the TAC and GSH-PX in plasma in AECOPD patients before treatment were significantly lower than those after treatment (all P < 0.01), the latter were still lower than those in the healthy persons (all P < 0.01). The plasma MDA in AECOPD patients before treatment was significantly higher than that after treatment (P < 0.01), which was still higher than that in the healthy persons (P < 0.05). There were negative correlations between TF/TFPI ratio and TAC (r = -0.518, P < 0.01), GSH-PX (r = -0.454, P < 0.05), PaO2 (r = -0.511, P < 0.01) respectively and a positive correlation between TF/TFPI ratio and the percentage of neutrophils (r = 0.379, P < 0.05) in AECOPD patients before treatment. There still were negative correlations between TF/TFPI ratio and TAC (r = -0.420, P < 0.05), FEV(1)% to predicted (r = -0.480, P < 0.05) respectively, and a positive correlation between TF/TFPI ratio and MDA (r = 0.451, P < 0.05) in AECOPD patients after treatment.

CONCLUSIONS

There existed coagulation/anticoagulation imbalance and oxidation/antioxidation imbalance before and after treatment in AECOPD patients and their relationship was explored.

摘要

目的

探讨慢性阻塞性肺疾病急性加重期（AECOPD）患者治疗前后凝血/抗凝失衡与氧化应激之间的关系。

方法

采用发色底物法检测28例AECOPD患者治疗前后及30例健康对照者血浆组织因子（TF）和组织因子途径抑制物（TFPI）活性。同时检测两组血浆总抗氧化能力（TAC）、丙二醛（MDA）和谷胱甘肽过氧化物酶（GSH-PX）水平。

结果

AECOPD患者治疗前血浆TF、TFPI水平及其比值（TF/TFPI）均显著高于治疗后（均P<0.01），治疗后仍高于健康人（均P<0.01）。AECOPD患者治疗前血浆TAC和GSH-PX水平显著低于治疗后（均P<0.01），治疗后仍低于健康人（均P<0.01）。AECOPD患者治疗前血浆MDA显著高于治疗后（P<0.01），且仍高于健康人（P<0.05）。治疗前AECOPD患者TF/TFPI比值与TAC（r=-0.518，P<0.01）、GSH-PX（r=-0.454，P<0.05）、动脉血氧分压（PaO2）（r=-0.511，P<0.01）分别呈负相关，与中性粒细胞百分比（r=0.379，P<0.05）呈正相关。治疗后AECOPD患者TF/TFPI比值与TAC（r=-0.420，P<0.05）、第1秒用力呼气容积占预计值百分比（FEV(1)%predicted）（r=-0.480，P<0.05）分别呈负相关，与MDA（r=0.451，P<0.05）呈正相关。