慢性阻塞性肺疾病患者肺组织中肺表面活性蛋白D的表达与临床意义

陈欣,曹洁.慢性阻塞性肺疾病患者肺组织中肺表面活性蛋白D的表达与临床意义[J].国际呼吸杂志,2013,33(5):337-341.

慢性阻塞性肺疾病 肺表面活性蛋白D

陈欣 曹洁

300052,天津医科大学总医院呼吸科

2013年

337-341

万方

目的 通过观察肺表面活性蛋白D(SP-D)在吸烟者与慢性阻塞性肺疾病(COPD)患者肺组织中的表达探究SP-D与COPD的关系.方法 通过免疫组织化学技术检测10例不吸烟非COPD、10例吸烟非COPD、10例吸烟COPD的患者的SP-D在气道上皮细胞、Ⅱ型肺泡上皮细胞和肺泡巨噬细胞的表达.结果 ①SP-D在气道上皮细胞的表达吸烟非COPD组强于COPD组(P=0.023),前两者又都强于不吸烟非COPD组(P＝0.000,P＝0.009)；②SP-D在Ⅱ型肺泡上皮细胞的表达吸烟非COPD组强于吸烟COPD组(P=0.015),前两者又都强于不吸烟非COPD组(P =0.00,P=0.022);③SP-D在肺泡巨噬细胞的表达吸烟非COPD组与吸烟COPD组无明显差异(P=0.313),但前两者都强于不吸烟非COPD组(P=0.00,P=0.005).在吸烟COPD组中,无论是气道上皮细胞、Ⅱ型肺泡上皮细胞还是肺泡巨噬细胞SP-D的表达强度与肺功能均呈正相关.结论 与不吸烟非COPD的人相比,吸烟非COPD和稳定期COPD患者的肺组织中SP-D的表达增强,而吸烟非COPD患者又比吸烟COPD患者SP-D的表达强,SP-D的表达强度与COPD患者的肺功能密切相关,吸烟可能是SP-D表达升高的重要诱因,SP-D表达的下降可能在COPD的发病机制中有重要作用,SP-D可能成为反应COPD严重程度的重要指标. Objective To investigate the expression of surfactant protein D (SP-D) in smokers and patients of chronic obstructive pulmonary disease (COPD),so as to demonstrate the possible association of SP-D with COPD.Methods The expression of SP-D was detected by immunohistochemical staining.Results ①The expression of SP-D in airway epithelial cells of smoker group was stronger than that in COPD group (P ＝0.023),which of control group was less than in smoker group and COPD group (P=0.000,P =0.009).②The expression of SP-D in alveolar type Ⅱ epithelial cells of smoker group was stronger than that in COPD group (P =0.015),which of control group was less than in smoker group and COPD group (P =0.00,P =0.022).③There was no difference in the expression of SP-D in alveolar macrophages between smoker group and COPD group (P ＝ 0.313),but the expression of SP-D in smoker group and COPD group was stronger than control group (P =0.00,P =0.005).In COPD group,the intensity of the expression of SP-D in airway epithelial cells,alveolar type Ⅱ epithelial cells and alveolar macrophages was positively correlated with FEV1 ％ pred and FEV1/FVC.Conclusions Compared with control group,the intensity of the expressions of SP-D in airway epithelial cells and in alveolar typeⅡ epithelial cells of the patients in smoker group and COPD group were stronger,and the expression of SP-D in smoker group was stronger than that in COPD group,the expression of SP-D in COPD group is positively correlated with lung function in COPD group,smoking may be the important incentive of the SP-D express rising,the decreasing of SP-D may play an important role in the pathogenesis of COPD.SP-D maybe the important index of reflecting the serious extent of COPD.。