Department of Pulmonary and Critical Care Medicine, Peking University Third Hospital, Beijing, 100191, People's Republic of China.
Department of Pulmonary and Critical Care Medicine, Beijing Hospital, National Center of Gerontology; Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, 100730, People's Republic of China.
Int J Chron Obstruct Pulmon Dis. 2021 Aug 10;16:2279-2289. doi: 10.2147/COPD.S314349. eCollection 2021.
To explore the relationship between endogenous hydrogen sulfide (HS) and high-resolution computed tomography (HRCT) indexes in pulmonary vascular remodeling.
A total of 94 stable chronic obstructive pulmonary disease (COPD) patients were recruited for the study.Plasma HS levels were measured using fluorescence probe. Fluorescence quantitative polymerase chain reaction was used to measure HS synthase cystathionine-γ-lyase (CSE) mRNA and cystathionine-β-synthesis enzyme (CBS) mRNA. The main pulmonary artery diameter (mPAD), axial diagonal mPAD, coronal mPAD, sagittal mPAD, right pulmonary artery diameter (RPAD), left pulmonary artery diameter (LPAD), and ascending aortic diameter (AAD) and the percentage of total cross-sectional area of vessels less than 5 mm of total lung area (%CSA <5) on HRCT were measured. Pulmonary arterial systolic pressure (PASP) of echocardiography, blood gas analysis, and routine blood tests were performed. Correlation analysis and multivariate linear regression were performed using SPSS 22.0.
HS was negatively correlated with mPAD, axial diagonal mPAD, and sagittal mPAD (r = -0.25-0.32) and positively correlated with PaO (r = 0.35). Relative expression of CSE mRNA was positively correlated with PASP, coronal mPAD, sagittal mPAD, white blood cell count (WBC), and neutrophil count (N) (r = 0.300.44). The relative expression of CBS mRNA was positively correlated with PASP, WBC, and N (r = 0.34~0.41). In separate models predicting pulmonary vascular indexes, a 1μmol/L increase in HS predicted lower pulmonary artery diameter (for axial diagonal mPAD, 0.76mm lower; for mPAD/AAD, 0.68mm lower). All values were less than 0.05.
Endogenous HS may be involved in pulmonary vascular remodeling, providing a new method for the diagnosis and treatment of COPD. The generation of HS may be inhibited by hypoxia, inflammation, etc.
探讨内源性硫化氢(HS)与肺血管重构高分辨率计算机断层扫描(HRCT)指标的关系。
共纳入 94 例稳定期慢性阻塞性肺疾病(COPD)患者。采用荧光探针法测定血浆 HS 水平,荧光定量聚合酶链反应法测定 HS 合酶胱硫醚-γ-裂解酶(CSE)mRNA 和胱硫醚-β-合成酶(CBS)mRNA。测量 HRCT 上主要肺动脉直径(mPAD)、轴向对角 mPAD、冠状 mPAD、矢状 mPAD、右肺动脉直径(RPAD)、左肺动脉直径(LPAD)和升主动脉直径(AAD)以及总肺面积小于 5mm 的血管总面积百分比(%CSA<5)。行超声心动图肺动脉收缩压(PASP)、血气分析及常规血常规检查。采用 SPSS 22.0 进行相关性分析和多元线性回归分析。
HS 与 mPAD、轴向对角 mPAD 和矢状 mPAD 呈负相关(r=-0.25-0.32),与 PaO 呈正相关(r=0.35)。CSE mRNA 相对表达与 PASP、冠状 mPAD、矢状 mPAD、白细胞计数(WBC)和中性粒细胞计数(N)呈正相关(r=0.300.44)。CBS mRNA 相对表达与 PASP、WBC 和 N 呈正相关(r=0.34~0.41)。在单独预测肺血管指数的模型中,HS 增加 1μmol/L 可预测肺动脉直径降低(轴向对角 mPAD 降低 0.76mm;mPAD/AAD 降低 0.68mm)。所有 P 值均小于 0.05。
内源性 HS 可能参与肺血管重构,为 COPD 的诊断和治疗提供了新方法。HS 的产生可能受到缺氧、炎症等因素的抑制。