本文關(guān)鍵詞：炎癥標(biāo)志物和自身抗體在慢性阻塞性肺疾病中的意義及與疾病加重的關(guān)系　出處：《華中科技大學(xué)》2014年博士論文　論文類型：學(xué)位論文

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【摘要】：研究背景 慢性阻塞性肺疾病(chronic obstructive pulmonary disease,COPD)是一種異質(zhì)性疾病,不僅存在肺部異常,也存在肺外全身系統(tǒng)的異常。單純依據(jù)肺功能檢查并不能充分描述疾病的復(fù)雜性,也不利于疾病的控制。近來(lái)的研究發(fā)現(xiàn)有一部分穩(wěn)定期COPD患者血液中炎癥標(biāo)志物的水平是升高的,有另一部分穩(wěn)定期COPD患者血液中可檢測(cè)到自身抗體,炎癥標(biāo)志物水平的升高與系統(tǒng)性炎癥相關(guān),自身抗體陽(yáng)性則與自身免疫相關(guān),兩種因素可能都參與了COPD的疾病進(jìn)展,并與預(yù)后存在一定的關(guān)系。 目的 本研究旨在明確穩(wěn)定期COPD中是否存在炎癥標(biāo)志物水平的升高和自身抗體的出現(xiàn),探索炎癥標(biāo)志物和自身抗體在COPD的意義及與COPD加重的關(guān)系。 方法 選擇穩(wěn)定期COPD患者和健康人入組,運(yùn)用ELISA法檢測(cè)血清中的炎癥標(biāo)志物：TNF-α IL-6. IL-8、CRP,運(yùn)用間接免疫熒光法檢測(cè)血清中的自身抗體：抗核抗體、抗彈力蛋白抗體。根據(jù)血液檢測(cè)結(jié)果對(duì)COPD患者分組并隨訪1年,收集COPD加重事件,分析炎癥標(biāo)志物、自身抗體與COPD加重的關(guān)系。 結(jié)果 穩(wěn)定期COPD患者入組75例,健康人入組20例,與健康對(duì)照組比較,有12例(16.0%) COPD患者血清中炎癥標(biāo)志物升高。有34例(45.3%)COPD患者血清中自身抗體陽(yáng)性。其中有9例(12%)患者同時(shí)存在系統(tǒng)性炎癥和自身免疫。相關(guān)性分析表明,IL-8與抗彈力蛋白抗體存在明顯的正相關(guān)關(guān)系(r=0.331,p=0.004)。在1年的隨訪時(shí)間里,炎癥標(biāo)志物升高的患者平均加重次數(shù)次明顯高于炎癥標(biāo)志物正常的患者[1.0(0.2)vs0.5(0.1),p=0.024],自身抗體陽(yáng)性的患者平均加重次數(shù)也明顯高于自身抗體陰性的患者[0.8(0.1)vs0.3(0.1),p=0.001]。 結(jié)論 有一部分穩(wěn)定期COPD患者血液中炎癥標(biāo)志物的水平會(huì)升高,提示系統(tǒng)性炎癥存在于COPD中,有另一部分穩(wěn)定期COPD患者血液中可檢測(cè)到自身抗體,提示自身免疫也存在于COPD中,炎癥標(biāo)志物與自身抗體正相關(guān),提示系統(tǒng)性炎癥與自身免疫存在相關(guān)性,兩種因素可能相互影響,共同參與了COPD的疾病進(jìn)展。炎癥標(biāo)志物升高(存在系統(tǒng)性炎癥)或自身抗體陽(yáng)性(存在自身免疫)的COPD患者可能具有更高的加重風(fēng)險(xiǎn)即更差的預(yù)后。
[Abstract]:Research background Chronic obstructive pulmonary disease (copd) is a heterogeneous disease. There are not only pulmonary abnormalities, but also abnormalities of the systemic system outside the lungs. The complexity of the disease can not be fully described by pulmonary function tests alone. Recent studies have found that levels of inflammatory markers in the blood of some stable COPD patients are elevated. Autoantibodies can be detected in the blood of other stable COPD patients. The increase of inflammatory markers is related to systemic inflammation, and autoantibody positive is associated with autoimmunity. Both factors may be involved in the progression of COPD and may be related to prognosis. Purpose The purpose of this study was to determine whether there were elevated levels of inflammatory markers and the presence of autoantibodies in stable COPD. To explore the significance of inflammatory markers and autoantibodies in COPD and its relationship with the aggravation of COPD. Method Patients with stable COPD and healthy persons were selected to enter the group. The inflammatory marker: TNF- 偽 IL-6. IL-8CRP in serum was detected by ELISA method. Indirect immunofluorescence assay was used to detect the autoantibodies in serum: antinuclear antibody and anti-elastin antibody. According to the results of blood test, the patients with COPD were divided into groups and followed up for one year to collect the aggravating events of COPD. To analyze the relationship between inflammatory markers, autoantibodies and COPD aggravation. Results 75 patients with stable COPD and 20 healthy persons were enrolled in the group, which was compared with the healthy control group. In 12 patients with COPD, the inflammatory markers were increased. 34 patients were positive for autoantibodies, 9 of them were positive for autoantibodies. Both systemic inflammation and autoimmunity were found in the patients. There was a significant positive correlation between IL-8 and anti-elastin antibody. The average exacerbation times of patients with elevated inflammatory markers were significantly higher than those with normal inflammatory markers. [The average exacerbation times of autoantibody positive patients were significantly higher than those of autoantibody negative patients. [(0. 0. 0. 0. 3, 0. 1 0. 0. 0. 0. 0. 0. 0. 0. 0. 1). Conclusion In some stable COPD patients, the level of inflammatory markers in the blood will increase, suggesting that systemic inflammation exists in COPD. Another part of stable COPD patients can detect autoantibodies in the blood, suggesting that autoimmunity also exists in COPD, inflammatory markers and autoantibodies are positively correlated. The results suggest that systemic inflammation is related to autoimmunity, and the two factors may influence each other. Co-involved in the progression of COPD. Elevated inflammatory markers (systemic inflammation) or autoantibodies (autoimmune). Ten percent of COPD patients may have a higher risk of exacerbation, or worse prognosis.
【學(xué)位授予單位】：華中科技大學(xué)
【學(xué)位級(jí)別】：博士
【學(xué)位授予年份】：2014
【分類號(hào)】：R563.9

【參考文獻(xiàn)】

相關(guān)期刊論文 前1條

1 Anna M. Stefanska;Patrick T. Walsh;;Chronic Obstructive Pulmonary Disease:Evidence for an Autoimmune Component[J];Cellular & Molecular Immunology;2009年02期

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本文編號(hào)：1366918