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华西医学  2012 

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

DOI: CNKI:51-1356/R.20120214.1341.014, PP. 213-217

Keywords: 同型半胱氨酸,维生素B6,硫化氢,氧化应激,慢性阻塞性肺疾病

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Abstract:

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

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