血清中性粒细胞弹性蛋白酶和α1-抗胰蛋白酶检测COPD的意义研究

摘要

目的 分析慢性阻塞性肺病患者的稳定期、急性加重期的中性粒细胞弹性蛋白酶(neutrophi l elastase,NE)和α1-抗胰蛋白酶(α1-AT)的变化状况,探索抗蛋白酶和蛋白酶失衡在慢性阻塞性肺疾病发病中的意义.方法 随机选取2009年2月到2012年1月慢性阻塞性肺疾病患者43例(稳定期21例、急性加重期22例),并取24例健康人作为对照,取血清标本,采用酶联免疫吸附法检测α1-AT、NE水平.结果 NE水平:健康对照组＜稳定期＜急性加重期,组间两两比较,差异均有显著性(P＜ 0.05);α 1-AT水平:急性加重期＜稳定期＜健康对照组,组间两两比较,差异均有显著性(p＜0.05).结论 α 1-AT、NE水平的失衡在慢性阻塞性肺疾病发病中有重要作用;α 1-AT的不足、NE水平升高与气道阻塞和气道炎症有紧密联系.%Objective To select patients with chronic obstructive pulmonary disease(COPD)and healthy people for comparative study and analysis during the stabilization period of the patients with COPD exacerbation of neutrophil elastase and α 1-antitrypsin(α 1-AT)change status,and the changes,risk factors and lung function indicators of relevance,and to explore the significance of anti-proteases and protease imbalance in the pathogenesis of COPD.Methods We randomly collected 43 cases of COPD from February 2009 to January 2012 as acute exacerbation group,and 24 cases of healthy people as controls,taking their serum samples,patients with COPD including 21 cases of acute exacerbation with the stabilization period among 22 cases to detect serum α 1-AT,NE level,using the enzyme-linked immunosorbent assay.Results NE level in normal control group was significantly lower than that of the acute exacerbation group,the difference was statistically significant(P＜ 0.01).the NE level of stabilization period was less than that of acute exacerbation with statistical significant difference(P＜ 0.05);Independent samples T-test results,acute exacerbation phase group α 1-AT level was significantly lower than that of the control group,the difference was statistically significant(P＜ 0.01);acute exacerbation α 1-AT levels below the stabilization period,the difference was statistically significant(P＜ 0.05).Conclusion The imbalance of α 1-AT and the NE level plays an important role in the pathogenesis of COPD;the α 1-AT deficiency and increase of NE level are closely associated with airway obstruction and airway inflammation.