甲型流感病毒感染致AECOPD的氧化應(yīng)激機(jī)制研究
發(fā)布時間：2019-02-19 18:39
【摘要】：目的：研究甲型流感病毒感染對慢性阻塞性肺疾病急性加重(Acute Exacerbation of Chronic Obstructive Pulmonary Disease AECOPD)患者氧化應(yīng)激和炎癥反應(yīng)的影響,并研究乙酰半胱氨酸對慢性阻塞性肺疾病急性加重的預(yù)防作用。方法：第一部分：選取152例AECOPD患者,用RT-PCR方法檢測病人痰液中RNA病毒,流感病毒陽性患者42例(流感組),陰性者110例(對照組),比較兩組患者誘導(dǎo)痰中丙二醛(MDA)、超氧化物岐化酶(SOD)、非酶性抗氧化劑微量還原型谷胱甘肽(GSH)水平及血漿中IL-6、IL-8水平,分析流感病毒表達(dá)與氧化應(yīng)激指標(biāo)、炎癥指標(biāo)的相關(guān)性。第二部分：將檢出的流感病毒陽性的42例病人病情好轉(zhuǎn)出院后,繼續(xù)服用乙酰半胱氨酸者(治療組)23例,未繼續(xù)用藥者(對照組)19例,跟蹤隨訪3個月,隨訪結(jié)束時測定誘導(dǎo)痰中SOD、MDA水平、及血漿炎癥因子(IL-6、IL-8)水平并比較兩組患者呼吸困難評分(MRC和BDI)、急性發(fā)作的次數(shù)。結(jié)果：第一部分：流感病毒感染患者42例。流感組誘導(dǎo)痰中MDA水平高于對照組,對照組誘導(dǎo)痰中SOD、GSH水平高于流感組,組間差別有統(tǒng)計學(xué)意義。流感組血漿IL-6和IL-8水平均高于對照組(P0.05)。流感組內(nèi),流感病毒表達(dá)強(qiáng)度與痰標(biāo)本中MDA水平正相關(guān)(r=0.557,P0.05),而痰標(biāo)本中MDA與血漿IL-8水平正相關(guān)(r=0.463,P0.05)。第二部分：治療后,治療組SOD水平明顯高于對照組,MDA、IL-8水平明顯低于對照組,治療組BDI高于對照組(p0.05),而兩組MRC評分無統(tǒng)計學(xué)差異。并且治療組急性發(fā)作的次數(shù)明顯低于對照組,差異均有統(tǒng)計學(xué)意義,P0.05。結(jié)論：第一部分：甲型流感病毒感染引起的慢性阻塞性肺疾病急性加重患者氣道氧化應(yīng)激狀態(tài)增強(qiáng)和全身炎癥增強(qiáng)。笫二部分：乙酰半胱氨酸可以調(diào)節(jié)機(jī)體的氧化與抗氧化失衡,長期服用可以降低AECOPD發(fā)作的次數(shù)。
[Abstract]:Objective: to study the effect of influenza A virus infection on oxidative stress and inflammatory response in patients with acute exacerbation of chronic obstructive pulmonary disease (Acute Exacerbation of Chronic Obstructive Pulmonary Disease AECOPD). To study the preventive effect of acetylcysteine on acute exacerbation of chronic obstructive pulmonary disease (COPD). Methods: the first part: select 152 patients with AECOPD, detect RNA virus in sputum by RT-PCR method, 42 cases of influenza virus positive patients (influenza group), 110 cases of negative cases (control group), compare the malondialdehyde (MDA), in induced sputum between the two groups. The levels of reduced glutathione (GSH) (GSH) and IL-6,IL-8 in plasma were determined by superoxide dismutase (SOD),) non-enzymatic antioxidant. The correlation between influenza virus expression and oxidative stress index and inflammation index was analyzed. The second part: 42 patients with positive influenza virus were treated with acetylcysteine (treatment group) and 19 patients (control group), and were followed up for 3 months. At the end of follow-up, the levels of SOD,MDA in induced sputum and plasma inflammatory factor (IL-6,IL-8) were measured and the respiratory dyspnea scores (MRC and BDI),) were compared between the two groups. Results: the first part: 42 cases of influenza virus infection. The level of MDA in induced sputum in influenza group was higher than that in control group, and the level of SOD,GSH in induced sputum in control group was higher than that in influenza group. The levels of plasma IL-6 and IL-8 in influenza group were higher than those in control group (P0.05). In the influenza group, the expression intensity of influenza virus was positively correlated with the level of MDA in sputum (r: 0.557 P 0.05), while the level of MDA in sputum was positively correlated with the level of plasma IL-8 (P 0.05). The second part: after treatment, the level of SOD in the treatment group was significantly higher than that in the control group, and the level of MDA,IL-8 in the treatment group was significantly lower than that in the control group. The BDI in the treatment group was higher than that in the control group (p0.05), but there was no significant difference in MRC score between the two groups. And the number of acute attack in the treatment group was significantly lower than that in the control group, the difference was statistically significant (P 0.05). Conclusion: the first part is the enhancement of airway oxidative stress and systemic inflammation in patients with acute exacerbation of chronic obstructive pulmonary disease caused by influenza A virus infection. Part two: acetylcysteine can regulate the imbalance of oxidation and anti-oxidation, long-term administration can reduce the number of AECOPD attacks.
【學(xué)位授予單位】：青島大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2013
【分類號】：R563.9
本文編號：2426753
[Abstract]:Objective: to study the effect of influenza A virus infection on oxidative stress and inflammatory response in patients with acute exacerbation of chronic obstructive pulmonary disease (Acute Exacerbation of Chronic Obstructive Pulmonary Disease AECOPD). To study the preventive effect of acetylcysteine on acute exacerbation of chronic obstructive pulmonary disease (COPD). Methods: the first part: select 152 patients with AECOPD, detect RNA virus in sputum by RT-PCR method, 42 cases of influenza virus positive patients (influenza group), 110 cases of negative cases (control group), compare the malondialdehyde (MDA), in induced sputum between the two groups. The levels of reduced glutathione (GSH) (GSH) and IL-6,IL-8 in plasma were determined by superoxide dismutase (SOD),) non-enzymatic antioxidant. The correlation between influenza virus expression and oxidative stress index and inflammation index was analyzed. The second part: 42 patients with positive influenza virus were treated with acetylcysteine (treatment group) and 19 patients (control group), and were followed up for 3 months. At the end of follow-up, the levels of SOD,MDA in induced sputum and plasma inflammatory factor (IL-6,IL-8) were measured and the respiratory dyspnea scores (MRC and BDI),) were compared between the two groups. Results: the first part: 42 cases of influenza virus infection. The level of MDA in induced sputum in influenza group was higher than that in control group, and the level of SOD,GSH in induced sputum in control group was higher than that in influenza group. The levels of plasma IL-6 and IL-8 in influenza group were higher than those in control group (P0.05). In the influenza group, the expression intensity of influenza virus was positively correlated with the level of MDA in sputum (r: 0.557 P 0.05), while the level of MDA in sputum was positively correlated with the level of plasma IL-8 (P 0.05). The second part: after treatment, the level of SOD in the treatment group was significantly higher than that in the control group, and the level of MDA,IL-8 in the treatment group was significantly lower than that in the control group. The BDI in the treatment group was higher than that in the control group (p0.05), but there was no significant difference in MRC score between the two groups. And the number of acute attack in the treatment group was significantly lower than that in the control group, the difference was statistically significant (P 0.05). Conclusion: the first part is the enhancement of airway oxidative stress and systemic inflammation in patients with acute exacerbation of chronic obstructive pulmonary disease caused by influenza A virus infection. Part two: acetylcysteine can regulate the imbalance of oxidation and anti-oxidation, long-term administration can reduce the number of AECOPD attacks.
【學(xué)位授予單位】：青島大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2013
【分類號】：R563.9
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