A Study About Systemic Oxidative Stress And Systemic Inflammation In Patients With Acute Exacerbation Of Chronic Obstructive Pulmonary Disease

Objective:To explore the relationships between oxidative stress and systemic inflammation in patients with AECOPD.Methods:Serum paraoxonase(PON1)activity was measured by phenyl acetate in 40 patients with AECOPD and 30 healthy persons.The IL-6 and IL-8 levels were detected by radioimmunoassay.The level of C-reactive protein(CRP)was measured by immune-reinforced turbidimetry.The malondialdehyde(MDA)level,glutathione peroxidase(GSH-Px)activity and total antioxidant capacity(TAC)were ed by chromatology.Results:(1)FEV₁(1.34±0.80)L,FEV₁ predict(FEV₁%)(37.10±13.24)% in AECOPD group were significantly lower than control group(2.38±0.57)L,(87.50±16.40)%(P＜0.01);FVC(2.29±0.43)L,FVC predict(FVC%)(60.80±10.98)%in AECOPD group were lower than control group(2.68±0.52)L,(98.20±11.40)% (P＜0.05);FEV₁/FVC%(55.23±7.49)%in AECOPD group was obviously lower than control group(90.76±12.20)%(P＜0.01).(2)The body mass index(BMI)(21.90±3.95)kg/m²,Ideal body weight per predict(IBW%)(99.40±8.6)%,mid-arm muscle circumference(20.78±1.85)cm in AECOPD group were lower than control group(23.15±3.36)kg/m²,(111.50±9.20)%,(24.88±3.35)cm(P＜0.05).The triceps skinfold thickness(16.23±3.20)mm was significantly lower than control group(20.88±4.01)mm(P＜0.01).(3)The activity of serum PON1[(95.03±57.4)U/mL],TAC[(9.86±3.19)NU/mL] in AECOPD group were significantly lower than control group[(136.0± 60.50)U/mL],[(18.42±8.23)NU/mL](P＜0.01);The GSH-Px[(128.46±28.27)U/mL] in AECOPD group was lower than control grouop[(186.60±39.50)U/mL](P＜0.05). The serum MDA in AECOPD[(6.25±0.87)nmol/mL]was significantly higher than control group[(3.65±0.54)nmol/mL](P＜0.01).(4)The level of CRP[(9.25±4.58)mg/L],IL-6[(64.86±20.27)pg/mL]in AECOPD group were significantly higher than control group[(3.34±1.29)mg/L],[(46.32±12.25)pg/mL](P＜0.01);The concentration of IL-8[(2.63±0.75)ng/mL]in AECOPD group was higher than in control group[(1.82±0.67)ng/mL](P＜0.05).(5)In AECOPD group,the level of IL-6 was related to triceps skinfold thickness and BMI(r=-0.642,-0.486,P＜0.01);IL-6 was positively related to dyspnea scale(r=0.330,P＜0.05);The FEV₁%was negatively related to CRP (r=-0.511,P＜0.01).(6)The BMI was related to GSH-Px activity(r=0.382,P＜0.05)and negatively related to MDA(r=-0.407,P＜0.01);The FEV₁%was positively related to PON1 activity(r=0.434,P＜0.05)and negatively related to MDA(r=-0.800,P＜0.01), positively related to TAC(r=0.357,P＜0.05).(7)The PON1 was negatively related to IL-8(r=-0.589,P＜0.01);Serum GSH-Px activity was negatively related to IL-6(r=-0.362,P＜0.05);MDA was significantly positively related to C-reactive protein(r=0.512,P＜0.01);Total antioxidant capacity was negatively related to IL-6 in AECOPD patients(r=-0.573,P＜0.01).Conclusions:There were malnutritional status,systemic inflammation and systemic oxidative stress in AECOPD group,the systemic inflammation and oxidative stress were both related to malnutritional status and the decrease of lung function in AECOPD.There were positive relationship between systemic inflammation and oxidative stress in patients with AECOPD.