慢性阻塞性肺疾病患者sTREM1测定及其意义.docVIP

慢性阻塞性肺疾病患者sTREM1测定及其意义 　【摘要】 目的 探讨慢性阻塞性肺疾病（COPD）患者外周血和诱导痰液中可溶性髓样细胞表达的激发受体1（sTREM1）的浓度及其与病情严重程度的关系。方法 分别测定12例COPD急性加重期（AECOPD）患者治疗前、治疗2周、稳定期的外周血和痰液中sTREM1的浓度及白细胞计数（WBC），以及12名健康人的外周血sTREM1的浓度。分析COPD各组外周血与痰液中sTREM1 浓度与第1秒用力呼气容积占预计值百分比（FEV1%预计值）的关系。 结果 COPD治疗前组和治疗2周组痰液中的sTREM1浓度都明显高于稳定期组（P＜0.05）。治疗前组、治疗2周组和稳定期组外周血中sTREM1与对照组比较均无显著性差异（P＞0.05）。COPD治疗前组痰液中的 sTREM1浓度与相对应FEV1%预计值呈负相关，对FEV1%影响从大到小依次为痰液sTREM1浓度和性别。结论 痰液中sTREM1浓度可以反映COPD气道炎症的程度并作为判断肺功能预后的参考指标，外周血sTREM1浓度并不能真实反映气道炎症严重的程度。 【关键词】 慢性阻塞性肺疾病；气道炎症；可溶性髓样细胞表达的激发受体1；白细胞计数；肺功能 ABSTRACT: Objective To investigate the contents of sTREM1 in peripheral blood and sputum from patients with COPD, and to analyze the correlation between sTREM1 and severity of COPD. Methods The levels of sTREM1 in peripheral blood and sputum were determined by ELISA in 12 acute exacerbation of COPD subjects, 2 weeks after treatment, stable COPD subjects, and 12 healthy individuals. The total white cell counts, pulmonary function tests were performed at the same time. The relationship between the content of sTREM1 in sputum from patients with acute exacerbation of COPD and FEV1 was analyzed. Results The content of sTREM1 in sputum from acute exacerbation of COPD group and 2 weeks after treatment was significantly higher than that in stable group, but in peripheral blood, they was no significant diference as compared with control group. The level of sTREM1 in sputum from acute exacerbation of COPD was significantly negative correlated with FEV1%. Conclusion The airway inflammation can be reflected by the content of sTREM1 in sputum from patients with acute exacerbation of COPD, and the level of sTREM1 may be a prognosis index of FEV1%. KEY WORDS: COPD;Airway inflammation;sTREM1;WBC;Pulmonary function 慢性阻塞性肺疾病（COPD）是以气道、肺实质和肺血管的慢性炎症为特征的病变[1]。研究表明[2]，感染为COPD急性加重的主要诱发因素，其中细菌感染在发病中起重要作用，而频繁的发作是肺功能下降的重要原因。Bouchon A等[3，4]鉴定出可溶性髓样细胞表达的激发受体1（soluble triggering receptor expressed on myeloid cell1，sTREM1）主要在中性粒细胞和单核细胞/巨噬细胞等髓系细胞上表达，并