【摘要】：目的：了解湖北省浩口地區(qū)農(nóng)村慢性阻塞性肺病患病率及危險因素；評價呼出氣冷凝水檢測(EBC)這一新的檢測手段在監(jiān)測慢性阻塞性肺病穩(wěn)定期患者氣道炎癥中的可行性和意義；并分析氧化應(yīng)激相關(guān)基因CYBA中第四號外顯子中242位點單核基因多態(tài)性與慢性阻塞性肺病易感性之間的關(guān)系。方法：以多階段抽樣方法,抽取浩口地區(qū)非干預(yù)村年齡≥40歲的農(nóng)村居民1554人進(jìn)行調(diào)查,采用統(tǒng)一的流行病學(xué)調(diào)查表格,并進(jìn)行體檢和肺功能檢測,以支氣管舒張試驗后(FEV1/FVC)×100%70%作為慢性阻塞性肺病的診斷標(biāo)準(zhǔn)。其中118名慢性阻塞性肺病患者及65名健康對照者進(jìn)行靜脈血、誘導(dǎo)痰及呼出氣冷凝水的采集,并用ELISA及EIA等方法檢測三種標(biāo)本中白細(xì)胞介素8、腫瘤壞死因子α、白三烯B4、8-異前列腺素以及瘦素的含量,評價慢性阻塞性肺病穩(wěn)定期患者氣道炎癥的程度、與全身性炎癥的關(guān)系以呼出氣冷凝水檢測的可行性。最后,提取兩組受試者的DNA,并利用限制性片段長度多態(tài)性技術(shù)對NADPH氧化酶P22PHOX亞基編碼基因CYBA的C242T的基因型和等位基因分布進(jìn)行檢測。結(jié)果：共檢出慢性阻塞性肺病患者173例,總患病率為11.13%.男性患病率為13.57%,女性患病率為7.44%,男性高于女性。隨年齡增高患病率逐漸上升。慢性阻塞性肺病患者以輕中度者為主(78.98%)。單因素分析表明,性別、年齡、吸煙、用生物燃料做飯、體重指數(shù)降低等5項因素與慢性阻塞性肺病有關(guān)。多因素logistic分析發(fā)現(xiàn),性別、年齡、吸煙為慢性阻塞性肺病的危險因素。慢性阻塞性肺病患者氣道炎癥標(biāo)志物及特異性的氧化應(yīng)激標(biāo)準(zhǔn)升高明顯,提示慢性阻塞性肺病穩(wěn)定期患者有慢性氣道炎癥存在。EBC檢測可以反應(yīng)患者氣道炎癥情況,但檢測方法尚待標(biāo)準(zhǔn)化。P22PHOX亞基編碼基因CYBA的C242T的單核苷酸基因多態(tài)性與慢性阻塞性肺病的易感性無關(guān)。結(jié)論：浩口地區(qū)農(nóng)村非干預(yù)村慢性阻塞性肺病患病率較高,防治意識及戒煙率差,亟需加強(qiáng)農(nóng)村地區(qū)人群的防治工作。EBC對于慢性阻塞性肺病患者氣道炎癥監(jiān)測有潛力,但檢測方法尚需進(jìn)一步優(yōu)化和規(guī)范。此外,慢性阻塞性肺病穩(wěn)定期患者的氣道炎癥過程明顯,應(yīng)給予規(guī)范的緩解期治療,以利于氣道炎癥的控制。P22PHOX亞基編碼基因CYBA的C242T的單核苷酸基因多態(tài)性與慢性阻塞性肺病的易感性無關(guān)。
[Abstract]:Objective: to investigate the prevalence and risk factors of chronic obstructive pulmonary disease (COPD) in rural areas of Haokou, Hubei Province, and to evaluate the feasibility and significance of detecting (EBC) in patients with chronic obstructive pulmonary disease (COPD) at stable stage. The relationship between the polymorphisms at locus 242in exon 4 of oxidative stress-related gene CYBA and the susceptibility to chronic obstructive pulmonary disease (COPD) was analyzed. Methods: 1554 rural residents aged more than 40 years old in non-interventional villages in Haokou area were selected by multi-stage sampling method. A unified epidemiological investigation form was used and physical examination and pulmonary function test were performed. Bronchodiastolic test (FEV1/FVC) 脳 100p% was used as diagnostic criteria for chronic obstructive pulmonary disease (COPD). Among them, 118 patients with chronic obstructive pulmonary disease and 65 healthy controls received venous blood, induced sputum and exhaled condensed water. The levels of interleukin-8 (IL-8), tumor necrosis factor 偽 (TNF- 偽), leukotriene B4-isoprostaglandin and leptin were measured by ELISA and EIA to evaluate the degree of airway inflammation in stable patients with chronic obstructive pulmonary disease (COPD). Relationship with systemic inflammation to detect the feasibility of exhaling condensate. Finally, DNA, was extracted from two groups of subjects and the genotypes and alleles of C242T of P22PHOX subunit encoding gene CYBA of NADPH oxidase were detected by restriction fragment length polymorphism (RFLP). Results: 173 cases of chronic obstructive pulmonary disease (COPD) were detected, the total prevalence rate was 11.13%. The prevalence rate of male was 13.57 and that of female was 7.44. The rate of male was higher than that of female. The prevalence rate increased with age. Patients with chronic obstructive pulmonary disease (COPD) were mainly mild to moderate (78.98%). Univariate analysis showed that 5 factors, such as sex, age, smoking, cooking with biofuel and lower body mass index, were associated with chronic obstructive pulmonary disease (COPD). Multivariate logistic analysis showed that sex, age and smoking were risk factors for chronic obstructive pulmonary disease (COPD). In patients with chronic obstructive pulmonary disease (COPD), markers of airway inflammation and specific oxidative stress criteria were significantly increased, indicating that chronic airway inflammation exists in patients with chronic obstructive pulmonary disease at stable stage. EBC detection can reflect the airway inflammation in patients with chronic obstructive pulmonary disease. However, the single nucleotide polymorphisms of C242T of P22PHOX subunit encoding gene CYBA were not associated with the susceptibility to chronic obstructive pulmonary disease (COPD). Conclusion: the prevalence rate of chronic obstructive pulmonary disease (COPD) in rural non-intervention villages in Haokou area is high, and the prevention and cure consciousness and smoking cessation rate are poor. It is urgent to strengthen the prevention and treatment of rural population. EBC has potential for monitoring airway inflammation in patients with chronic obstructive pulmonary disease (COPD). However, the detection method still needs to be optimized and standardized. In addition, chronic obstructive pulmonary disease patients with stable airway inflammation process is obvious, should be given standard remission treatment, The single nucleotide polymorphisms of C242T in P22 PHOX subunit coding gene CYBA were not associated with the susceptibility to chronic obstructive pulmonary disease (COPD).
【學(xué)位授予單位】：華中科技大學(xué)
【學(xué)位級別】：博士
【學(xué)位授予年份】：2012
【分類號】：R563.9

【共引文獻(xiàn)】

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