葡萄籽原花青素对慢性阻塞性肺疾病合并阻塞性睡眠呼吸暂停患者氧化应激和炎症反应的影响

摘要

Objective To explore the effects of grape seed proanthocyanidin(GSP) on inflammation and oxidative stress in patients of overlap syndrome(OS) which was chronic obstructive pulmonary disease (COPD) combined with obstructive sleep apnea hypopnea syndrome (OSAHS).Methods Ninety patients of OS were divided into the control group(43 cases) and the observation group(47 cases).Patients in the two groups were received routine treatment of OS and patients in the observation group were treated by GSP (200 mg/d,4 weeks).Plasma interleukin (IL)-1,IL-6,tumor necrosis factor (TNF)-α,malondialdehyde (MDA) and superoxide dismutase(SOD) were detected and pulmonary function test,blood gas analysis,polysomnography(PSG) and assessment of life quality were conducted in the two group before and after treatment.Results Compared with those before treatment,levels of plasma IL-1,IL-6,TNF-α,MDA,arterial partial pressure of carbon dioxide (PaCO2) and apnea hypopnea index (AHI) all decreased,and level of SOD,percentage of 1 second force expiratory volume(FEV1)/estimated value(FEV1％ predict),percentage of FEV1/forced vital capacity (FVC,FEV1/FVC),arterial partial pressure of oxygen (PaO2),minimum pulse oxygen saturation (LSpO2),scores of physiological role (PR),general health perceptions (GH),vitality (VT),social function (SF),role limitations due to emotional problems (RE) and mental health (MH) all increased in the two group after treatment(P ＜ 0.05).Levels of plasma IL-1,IL-6,TNF-α,MDA,PaCO2 and AHI in the observation group after treatment were all lower than those in the control group,and levels of SOD,FEV1 ％ predict,FEV1/FVC,PaO2,LSpO2,PR,GH,VT,SF,RE and MH were all higher than those in the control group (P ＜ 0.05).Conclusion GSP can reduce the levels of inflammation and oxidative stress in patients of OS.%目的 探讨葡萄籽原花青素(GSP)对慢性阻塞性肺疾病(COPD)合并阻塞性睡眠呼吸暂停(OSAHS)的重叠综合征(OS)患者氧化应激和炎症反应的影响.方法 将90例OS患者随机分为对照组43例和观察组47例.两组患者均给予OS常规治疗,同时观察组应用GSP 200 mg/d,疗程4周.治疗前后分别检测两组患者血浆白细胞介素(IL)-1、IL-6、肿瘤坏死因子(TNF)-α、丙二醛(MDA)和超氧化物歧化酶(SOD)水平并进行肺功能检查、血气分析、多导睡眠监测(PSG)及生存质量评定.结果 与治疗前比较,治疗后两组患者血浆IL-1、IL-6、TNF-α、MDA水平、动脉血二氧化碳分压(PaCO2)和呼吸暂停低通气指数(AHI)均降低,SOD水平、第1秒用力呼气容积(FEV1)占预计值百分比(FEV1％预计值)、FEV1与用力肺活量(FVC)的比值(FEV1/FVC)、动脉血氧分压(PaO2)、最低脉搏血氧饱和度(LSpO2)、生理职能(RP)、健康状况(GH)、生活活力(VT)、社会功能(SF)、情绪角色功能(RE)及精神健康(MH)评分均升高(P＜0.05).治疗后观察组血浆IL-1、IL-6、TNF-α、MDA水平、PaCO2及AHI均低于对照组,SOD水平、FEV1％预计值、FEV1/FVC、PaO2、LSpO2、RP、GH、VT、SF、RE及MH评分均高于对照组(P＜0.05).结论 GSP可降低OS患者体内氧化应激和炎症反应水平.