本文選題：空氣污染 + 顆粒物��； 參考：《北京大學(xué)學(xué)報(bào)(醫(yī)學(xué)版)》2017年03期

【摘要】：目的:研究環(huán)境大氣顆粒物及多環(huán)芳烴(polycyclic aromatic hydrocarbons,PAHs)暴露對慢性阻塞性肺疾病(chronic obstructive pulmonary disease,COPD)患者全身性氧化應(yīng)激水平的影響。方法:招募45名居住在北京大學(xué)醫(yī)學(xué)部半徑5 km范圍內(nèi)的COPD患者作為研究對象,采用定組研究方法,于2014年11月至2015年5月對研究對象進(jìn)行兩次臨床隨訪。通過肺功能檢查測定第1秒用力呼氣容積占預(yù)計(jì)值百分比(即FEV1%預(yù)計(jì)值),用于評估COPD患者病情的嚴(yán)重程度。收集患者尿樣,分別采用高效液相色譜(high performance liquid chromatography,HPLC)法和酶聯(lián)免疫吸附測定(enzyme-linked immunosorbent assay,ELISA)法測定尿樣中的全身性氧化應(yīng)激指標(biāo)丙二醛(malondialdehyde,MDA)和8-羥基脫氧鳥苷(8-hydroxy-2'-deoxyguanosine,8-OHd G)水平,同時(shí),通過本課題組于校園內(nèi)自行建立的空氣污染監(jiān)測站點(diǎn)連續(xù)收集研究期間該區(qū)域的環(huán)境大氣污染物濃度以獲得人群污染物暴露水平。利用線性混合效應(yīng)模型,分別通過單污染物模型、雙污染物模型和分層分析來研究大氣污染物對COPD患者尿樣中MDA和8-OHd G水平的影響。結(jié)果:滯后2 d(lag2)的超細(xì)顆粒物(ultrafine particles,UFP)和PAHs濃度與尿樣中MDA水平呈顯著正相關(guān)(P0.05),UFP和PAHs每升高四分位間距(interquartile range,IQR)濃度,MDA濃度分別升高28%(95%CI:4%~57%)和36%(95%CI:4%~77%),控制黑碳(black carbon,BC)的影響后,UFP和PAHs與MDA的關(guān)聯(lián)強(qiáng)度略有升高。以COPD的嚴(yán)重程度進(jìn)行分層分析后發(fā)現(xiàn),多數(shù)污染物在疾病程度較輕的COPD患者中具有更強(qiáng)的氧化應(yīng)激效應(yīng)。在FEV1%預(yù)計(jì)值≥50%的COPD患者中發(fā)現(xiàn),UFP每升高IQR濃度,尿樣中MDA濃度升高98%(95%CI:38%~186%),BC、UFP和PAHs每升高IQR濃度,尿樣中8-OHd G濃度分別升高87%(95%CI:32%~166%)、69%(95%CI:24%~130%)和156%(95%CI:66%~294%)。本研究未觀察到細(xì)顆粒物(fine particulate matter,PM_(2.5))與尿樣中氧化應(yīng)激指標(biāo)的顯著關(guān)聯(lián)。結(jié)論:大氣污染物暴露可加重COPD患者全身性氧化應(yīng)激水平,其中UFP和PAHs的效應(yīng)更為顯著,并且污染物對于疾病程度較輕的COPD患者氧化應(yīng)激效應(yīng)更強(qiáng)。
[Abstract]:Aim: to study the effects of environmental atmospheric particulates and polycyclic aromatic hydrocarbonization (PAHs) on systemic oxidative stress in patients with chronic obstructive pulmonary disease (COPD). Methods: 45 COPD patients living within 5 km radius of Peking University Department of Medicine were recruited as study subjects. The subjects were followed up twice from November 2014 to May 2015. The forced expiratory volume in the first second (FEV 1%) was measured by pulmonary function test to evaluate the severity of COPD patients. Urine samples were collected and the levels of malondialdehyde (MDA) and 8-hydroxy-2deoxyguanosine 8-OHd (8-hydroxy-2deoxyguanosine) were determined by high performance liquid chromatography (HPLC) and enzyme-linked immunosorbent assayanosa (Elisa). The concentration of atmospheric pollutants in the area was collected continuously by the air pollution monitoring station set up by our group in order to obtain the exposure level of pollutants in the population. The effects of atmospheric pollutants on the levels of MDA and 8-OHd G in urine samples of COPD patients were studied by single pollutant model, double pollutant model and stratified analysis using linear mixed effect model. Results: the concentrations of ultrafine particles (UFPV) and PAHs in urine were significantly positively correlated with the levels of MDA in urine samples. The concentrations of UFP and PAHs increased 2895CI45757) and 3695% CI: 477%, respectively, in order to control the effects of black carbon (UFP) and PAHs. The correlation strength with MDA increased slightly. By stratified analysis of the severity of COPD, it was found that most pollutants had stronger oxidative stress effects in patients with mild COPD. In patients with COPD with FEV1% predicted value 鈮，

本文編號：1911331