%0 Journal Article
%T 同型半胱氨酸转硫途径和维生素B6及内源性硫化氢在慢性阻塞性肺疾病急性加重期的作用
%A 赵丽
%A 文富强
%A 左秋南
%A 王业
%A 陈磊
%A 汪涛
%J 华西医学
%P 213-217
%D 2012
%R CNKI:51-1356/R.20120214.1341.014
%X 目的　研究同型半胱氨酸转硫途径、维生素B6及内源性硫化氢在慢性阻塞性肺疾病急性加重期（AECOPD）中的作用。方法　2010年2月－4月间筛选AECOPD患者16例和健康志愿者（对照组）13例，测定AECOPD患者加重期、缓解期及对照组的肺功能、血清硫化氢（H2S）、丙二醛（MDA）、叶酸、维生素B12、C反应蛋白、白介素6、血浆同型半胱氨酸、胱硫醚、半胱氨酸和维生素B6的浓度。计算半胱氨酸转化率（半胱氨酸浓度/胱硫醚浓度）与胱硫醚转化率（胱硫醚浓度/同型半胱氨酸浓度）参与分析。结果　①加重期血清MDA水平（7.3±5.1）nmol/L比缓解期（3.0±1.4）nmol/L和对照组（3.0±2.2）nmol/L均升高（P＜0.01）；血清MDA水平与第1秒用力呼气容积/用力肺活量（FEV1/FVC）、第1秒用力呼气容积占预计值百分比（FEV1%预计值）呈负相关。②加重期血清H2S水平与血浆维生素B6水平较缓解期与对照组降低（P＜0.01）；缓解期血清H2S水平（47.2±5.1）μmol/L高于对照组（38.8±2.1）μmol/L，P＜0.01；血清H2S水平、血浆维生素B6水平均与FEV1%预计值呈正相关（r=0.651、0.680，P＜0.01），均与血清MDA水平呈负相关（r=-0.334、-0.448，P＜0.05）。③加重期半胱氨酸转化率（3.97±2.41）低于缓解期（5.92±2.18）与对照组（6.14±3.15）差异有统计学意义（P＜0.05）；而胱硫醚转化率则相反。④叶酸与维生素B12水平各组间均无差异。结论　提高AECOPD患者维生素B6及H2S浓度可能能促使AECOPD患者向稳定状态转归，减轻氧化应激损伤。维生素B6与H2S可能成为AECOPD患者的一个新的治疗点。ObjectiveTostudytherolesofhomocysteine(Hcy)transsulfurationpathway,VitaminB6andendogenoushydrogensulfideintreatingpatientswithacuteexacerbationofchronicobstructivepulmonarydisease(AECOPD).Methods　SixteenAECOPDpatientsand13healthycontrols(Controlgroup)fromFebruarytoApril2010wererecruitedinthisstudy.Lungfunction,serumhydrogensulfide(H2S),malondialdehyde(MDA),folate,vitaminB12,C-reactiveprotein(CRP),interleukin-6(IL-6),Hcy,cystathionine,cystein(Cys)andvitaminB6wereallmeasuredforallthepatientsintheacuteexacerbationperiodandalleviationperiodandhealthycontrols.TheconversionrateofCys(expressedasCys/cystathionine)andtheconversionrateofcystathionine(expressedascystathionine/Hcy)werecalculatedforanalysis.Results　SerumMDAlevelforpatientsintheacuteexacerbationperiod(AEperiod)(7.3±5.1)nmol/Lwassignificantlyhigherthanthatinthealleviationperiod(3.0±1.4)nmol/Landinthehealthycontrols(3.0±2.2)nmol/L(P＜0.01).SerumMDAlevelwasnegativelycorrelatedwithpercentageofFEV1inpredictedFEV1(FEV1%pred)andFEV1/FVC.SerumH2SlevelandplasmavitaminB6levelforpatientsintheAEperiodweresignificantlylowerthanthoseinthealleviationperiodandinthehealthycontrols(P＜0.01),andserumH2Slevelwassignificantlyhigherinthealleviationperiod(47.2±5.1)μmol/Lthaninthecontrols(38.8±2.1)μmol/L(P＜0.01).BothserumH2SandplasmavitaminB6levelswerecorrelatedpositivelywithFEV1%predforpatientsintheAEperiodandhealthycontrols(r=0.651,0.680;P＜0.01),butnegativelycorrelatedwithserumMDAlevel(r=-0.334,-0.448;P＜0.05).TheconversionrateofCysforpatientsintheAEperiod(3.97±2.41)wassignificantlylowerthanthatinthealleviationperiod(5.92±2.18)andthecontrolgroup(6.14±3.15)(P＜0.05),buttheconversionrateofcystathioninewasjusttheopposite(P＜0.05).TherewerenosignificantdifferencesinthelevelsofserumfolateandvitaminB12amongthethreegroups.Conclusion　RaisingtheVitaminB6andH2Slevelmayfacilitatestabilizingofcon
%K 同型半胱氨酸
%K 维生素B6
%K 硫化氢
%K 氧化应激
%K 慢性阻塞性肺疾病
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