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目的 观察血红素氧合酶 (HO)在慢性阻塞性肺疾病 (COPD)患者中的表达及其变化。方法 设COPD组、COPD合并肺癌组、单纯肺癌组及正常健康组。 4组均进行血气分析和肺功能测定。应用紫外分光光度计间接测定动脉血一氧化碳血红蛋白 (COHb)含量和肺脏HO 1的活性。用逆转录 聚合酶链反应检测肺脏和肺动脉组织HOmRNA表达水平。用免疫组化法测定肺脏组织HO蛋白的表达。结果 COPD组和COPD合并肺癌组患者动脉血氧分压低于 60mmHg(1mmHg =0 .1 33kPa) ,提示这两组患者均为Ⅰ型呼吸衰竭患者。与正常健康组比较 ,这两组患者的肺一氧化碳弥散量、肺一氧化碳弥散量 /肺泡通气量及 1秒钟用力呼气容积占预计值的百分比均显著降低 ,残气容积 /肺总量显著升高 ,提示这两组患者均患有中度COPD(Ⅱ级 )。这两组患者的COHb明显高于单纯肺癌组和正常健康组 (P <0 0 1 ) ,单纯肺癌组和正常健康组比较差异无显著性。COPD合并肺癌组患者胆红素生成量、肺脏及肺动脉组织HO 1mRNA吸光度值明显高于单纯肺癌组和正常健康组。HO 1免疫组化染色显示 ,COPD合并肺癌组非癌变肺组织肺泡壁细胞、肺内小血管和支气管壁细胞胞质HO 1的表达显著增强。结论 COPD患者HO 1表达增多。
Objective To observe the expression and change of heme oxygenase (HO) in patients with chronic obstructive pulmonary disease (COPD). Methods COPD group, COPD with lung cancer group, simple lung cancer group and normal healthy group. Blood gas analysis and pulmonary function tests were performed in all 4 groups. Indirect determination of arterial carbon monoxide hemoglobin (COHb) content and lung HO 1 activity by UV spectrophotometer. HOmRNA expression levels in lung and pulmonary artery were detected by reverse transcription polymerase chain reaction. Immunohistochemistry was used to determine the expression of HO protein in lung tissue. Results The partial pressure of arterial oxygen in patients with COPD and COPD with lung cancer was less than 60mmHg (1mmHg = 0.133kPa), suggesting that both patients were type Ⅰ patients with respiratory failure. Compared with the control group, the percentages of carbon monoxide dispersion, carbon-carbon dioxide diffusion / alveolar ventilation and forced expiratory volume per second in both groups were significantly lower than those in the normal group, and the residual volume / total lung volume significantly increased High, suggesting that both groups of patients had moderate COPD (grade II). The COHb in both groups was significantly higher than that in simple lung cancer group and normal healthy group (P <0.01). There was no significant difference between simple lung cancer group and normal healthy group. Bilirubin production in COPD patients with lung cancer was significantly higher than that in lung cancer and normal controls. HO 1 immunohistochemical staining showed that the expression of HO 1 in alveolar wall cells, small pulmonary vessels and bronchial wall cells of COPD patients with lung cancer was significantly increased. Conclusion COP1 patients HO1 expression increased.