Liu Hu, Xu Jian-ying
Department of Respiratory Medicine, Dayi Hospital Affiliated to Shanxi Medical University, Taiyuan, China.
Zhonghua Jie He He Hu Xi Za Zhi. 2012 Oct;35(10):758-61.
To measure the levels of 4-hydroxynonenal (4-HNE), TNF-α and IL-6 in patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD) and stable COPD, and therefore to explore the role of 4-HNE in the assessment of COPD severity.
A total of 242 patients with AECOPD, 182 males and 60 females, age 54 - 89 (mean 72 ± 8) years, 57 outpatients with stable COPD, 55 males and 2 females, age 38 - 76 (mean 60 ± 8) years, and 67 healthy controls, 49 males and 18 females, age 42 - 86 (mean 66 ± 10) years, were included in the study. Based on whether there were respiratory failure, chronic pulmonary heart disease or a history of smoking, the patients with AECOPD were divided into different subgroups. Patients with stable COPD were divided into different subgroups based on lung function or whether there was a history of smoking. The serum 4-HNE, TNF-α and IL-6 concentrations were measured by using enzyme-linked immune sorbent assay (ELISA).
The serum 4-HNE levels in patients with AECOPD or stable COPD (16 ± 4) mg/L, (15 ± 5) mg/L were higher than those in healthy controls (12 ± 4) mg/L (both P < 0.01). After control for age, the serum 4-HNE levels in patients with AECOPD were significantly higher than those in stable COPD (F = 7.93, P < 0.01). There were no differences in the serum 4-HNE among AECOPD patients of current smokers, non-smokers and ex-smokers (16 ± 4) mg/L, (17 ± 3) mg/L, (17 ± 4) mg/L. The serum 4-HNE in AECOPD patients with chronic pulmonary heart disease were particularly higher (17 ± 4) mg/L vs (15 ± 4) mg/L (F = 1.23, P < 0.01). There were no differences in the serum 4-HNE between stable COPD patients of current smokers and ex-smokers (14 ± 5) mg/L, (16 ± 4) mg/L (t = -1.44, P > 0.05). In patients with stable COPD, the serum 4-HNE levels were significantly correlated with FEV(1)% (r = -0.345, P < 0.01) and IL-6 (r = 0.363, P < 0.01).
The serum levels of 4-HNE in COPD patients with different smoking status were all significantly elevated, particular in patients with acute exacerbation and with pulmonary heart disease. In patients with stable COPD, the 4-HNE levels were negatively correlated with FEV(1)% and positively with serum IL-6 levels. It may be a valuable biomarkers for the assessment of COPD severity.
检测慢性阻塞性肺疾病急性加重期（AECOPD）患者和稳定期慢性阻塞性肺疾病（COPD）患者血清中4-羟基壬烯醛（4-HNE）、肿瘤坏死因子-α（TNF-α）和白细胞介素-6（IL-6）水平，探讨4-HNE在评估慢性阻塞性肺疾病严重程度中的作用。
本研究共纳入242例AECOPD患者，其中男性182例，女性60例，年龄54 - 89岁（平均72±8岁）；57例稳定期COPD门诊患者，其中男性55例，女性2例，年龄38 - 76岁（平均60±8岁）；67例健康对照者，其中男性49例，女性18例，年龄42 - 86岁（平均66±10岁）。根据是否合并呼吸衰竭、慢性肺源性心脏病或吸烟史，将AECOPD患者分为不同亚组。根据肺功能或吸烟史将稳定期COPD患者分为不同亚组。采用酶联免疫吸附测定（ELISA）法检测血清4-HNE、TNF-α和IL-6浓度。
AECOPD患者和稳定期COPD患者血清4-HNE水平分别为（16±4）mg/L、（15±5）mg/L，均高于健康对照者的（12±4）mg/L（P均<0.01）。校正年龄后，AECOPD患者血清4-HNE水平显著高于稳定期COPD患者（F = 7.93，P < 0.01）。AECOPD患者中，当前吸烟者、非吸烟者和既往吸烟者血清4-HNE水平差异无统计学意义（分别为（16±4）mg/L、（17±3）mg/L、（17±4）mg/L）。合并慢性肺源性心脏病的AECOPD患者血清4-HNE水平尤其高（17±4）mg/L对（15±4）mg/L（F = 1.23，P < 0.01）。稳定期COPD患者中，当前吸烟者和既往吸烟者血清4-HNE水平差异无统计学意义（分别为（14±5）mg/L、（16±4）mg/L，t = -1.44，P > 0.05）。在稳定期COPD患者中，血清4-HNE水平与第1秒用力呼气容积占预计值百分比（FEV(1)%）呈显著负相关（r = -0.345，P < 0.01），与IL-6呈正相关（r = 0.363，P < 0.01）。
不同吸烟状态的COPD患者血清4-HNE水平均显著升高，尤其是急性加重期患者和合并肺源性心脏病患者。在稳定期COPD患者中，4-HNE水平与FEV(1)%呈负相关，与血清IL-6水平呈正相关。它可能是评估COPD严重程度的一个有价值的生物标志物。
