中国呼吸与危重监护杂志

中国呼吸与危重监护杂志

慢性阻塞性肺疾病伴或不伴低氧血症患者外周血 MCP-1、SAA 蛋白及 mRNA 水平与认知功能损伤关系探讨

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目的 探讨慢性阻塞性肺疾病(简称慢阻肺)伴或不伴低氧血症患者血清单核细胞趋化蛋白-1(MCP-1)、血清淀粉样蛋白 A(SAA)水平与认知功能的关系,以期为慢阻肺患者筛查预测早期认知功能损伤的血清学指标,同时探讨低氧血症在认知障碍发生中的作用。 方法 纳入 2013 年 1 月至 2017 年 1 月于华北理工大学附属医院住院的 62 例慢阻肺患者,依据血气分析将其分为慢阻肺缺氧组(25 例)和慢阻肺无缺氧组(37 例),同期 30 例健康体检人群为对照组。采用酶联免疫吸附法测定慢阻肺患者及对照人群血清 MCP-1、SAA 浓度,逆转录聚合酶链反应检测外周血单核细胞中 MCP-1、SAA 的 mRNA 表达水平,应用蒙特利尔认知评估量表(MoCA 量表)进行认知功能测定。分析三组人群在血清 MCP-1、SAA 水平及外周血 MCP-1 mRNA、SAA mRNA 水平表达有无差异及与认知功能损伤的关系。 结果 血清 MCP-1、SAA 水平及外周血单核细胞 MCP-1 mRNA、SAA mRNA 水平表达水平趋势一致,慢阻肺患者血清 MCP-1、SAA 水平及外周血单核细胞 MCP-1 mRNA、SAA mRNA 水平高于健康对照组,差异有统计学意义(均 P<0.05);慢阻肺缺氧组和慢阻肺无缺氧组 MoCA 评分总分较对照组低,其中缺氧组 MoCA 评分降低更明显,差异有统计学意义(均P<0.05)。血清 SAA、MCP-1 水平及外周血单核细胞 MCP-1 mRNA、SAA mRNA 水平与 MoCA 总分呈负相关(均P<0.05)。 结论 慢阻肺患者血清 SAA、MCP-1 水平及外周血单核细胞 MCP-1 mRNA、SAA mRNA 水平高低与患者认知障碍程度呈正相关,低氧血症可能是慢阻肺患者发生认知功能受损的因素之一。

Objective To explore the correlation of protein and mRNA levels of monocyte chemotactic protein-1 (MCP-1) and serum amyloid A protein (SAA) with cognitive function in chronic obstructive pulmonary disease (COPD) patients with or without hypoxemia, in order to identify the serum indexes of early cognitive impairment in patients with COPD, and investigate the effect of hypoxemia on cognitive impairment. Methods Sixty-two COPD patients admitted in the respiratory department of Affiliated Hospital of North China University of Science and Technology from January 2013 to January 2017 were included in the study. The COPD patients were divided into a hypoxemia group (25 cases) and a non-hypoxemia group (37 cases) according to blood gas analysis. Meanwhile 30 healthy subjects were recruited as control. ELISA was used to measure the concentration of serum MCP-1 and SAA in all subjects, and RT-PCR was used to detect the mRNA expression of MCP-1 and SAA in peripheral blood mononuclear cells. Montreal cognitive assessment scale (MoCA scale) was used to determine cognitive function. The expression levels of MCP-1 and SAA were compared between three groups, and the correlations with cognitive dysfunction were analyzed. Results The expression levels of serum MCP-1 and SAA had the same trend as those of MCP-1 mRNA and SAA mRNA in peripheral blood in the COPD patients. The protein and mRNA levels of MCP-1 and SAA were higher than those in the healthy control group (all P<0.05). The COPD hypoxemia group and the COPD non-hypoxemia group were lower than the control group in MoCA score, and the MoCA score of the COPD hypoxemia group decreased more obviously (allP<0.05). The protein and mRNA levels of SAA and MCP-1 were negatively correlated with MoCA score (allP<0.05). Conclusion The protein and mRNA levels of MCP-1 and SAA in peripheral blood increase in COPD patients, and hypoxemia may be involved in cognitive dysfunction in COPD patients.

关键词: 慢性阻塞性肺疾病; 认知功能障碍; 单核细胞趋化蛋白-1; 淀粉样蛋白 A; 低氧血症

Key words: Chronic obstructive pulmonary disease; Cognitive dysfunction; Monocyte chemotactic protein-1; Amyloid A protein; Hypoxemia

引用本文: 戈艳蕾, 刘聪辉, 张嘉宾, 崔紫阳, 李立群, 张盼盼, 谭曦舒, 王红阳. 慢性阻塞性肺疾病伴或不伴低氧血症患者外周血 MCP-1、SAA 蛋白及 mRNA 水平与认知功能损伤关系探讨. 中国呼吸与危重监护杂志, 2018, 17(4): 327-330. doi: 10.7507/1671-6205.201711033 复制

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