• 四川大學華西醫(yī)院（成都，610041）1呼吸內(nèi)科，2普通內(nèi)科;

目的 　探討慢性阻塞性肺疾病（COPD）患者中微量元素銅和鋅與炎癥介質的關系。 方法 　2010年11月－2011年3月間測量15例COPD急性加重期患者入院時及治療后和13例健康者為對照組的血清銅、鋅、C反應蛋白（CRP）、白介素-6（IL-6），血漿中金屬硫蛋白，以及氧化應激產(chǎn)物丙二醛的濃度變化。并對銅、鋅濃度變化與CRP、IL-6進行相關分析。 結果 　COPD組血清中銅濃度、CRP、IL-6水平高于對照組（P＜0.05），同時急性加重期患者血清中銅的濃度、CRP、IL-6水平以及丙二醛值高于緩解期患者（P＜0.05）。而急性加重期患者血清中鋅濃度低于緩解期組和對照組（P＜0.05）。血漿中抗氧化物質金屬硫蛋白在三組間差異無統(tǒng)計學意義（P＞0.05）。在微量元素與炎癥因子的相關分析中發(fā)現(xiàn)，銅與CRP（r=0.602，P＜0.001）、IL-6（r=0.533，P＜0.001）呈正相關，鋅與IL-6呈負相關（r=?0.336，P＜0.05）。 結論 　在COPD氧化應激發(fā)病機制中，銅可能發(fā)揮促氧化應激的作用，而鋅可能發(fā)揮抗氧化應激的作用。微量元素穩(wěn)態(tài)的紊亂有可能是COPD急性加重的危險因素。

引用本文： 左秋南,趙麗,王業(yè),文富強. 慢性阻塞性肺疾病患者血清中微量元素濃度變化及作用. 華西醫(yī)學, 2012, 27(4): 517-520. doi: 復制

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14. 　Morrison D, Rahman I, Lannan S, et al. Epithelial permeability, in?ammation, and oxidant stress in the air spaces of smokers[J]. Am J Respir Crit Care Med, 1999, 159(2): 473-479.
15. 　Rahman I, Skwarska E, MacNee W. Attenuation of oxidant/antioxidant imbalance during treatment of exacerbations of chronic obstructive pulmonary disease[J].Thorax, 1997, 52(6): 565-568.
16. 　Quilliot D, Dousset B, Guerci B, et al. Evidence that diabetes mellitu favors impaired metabolism of zinc, copper and selenium in chronic pancreatitis[J]. Pancreatitis, 2001, 22(3):299-306.
17. 　Fabisiak JP, Tyurin VA, Tyurina YY, et al. Redox regulation of copper-metallothionein[J].Arch Biochem Biophys, 1999, 363(1): 171-181.
18. 　Rasad AS. Zinc in human health: an update[J]. Trace Elem Exp Med, 1998, 11(2-3): 63-87.
19. 　Kiril G, Hamdi Muz M, Seckin D, et al. Antioxidant effect of zinc picolinate in patients with chronic obstructive pulmonary disease[J]. Respir Med, 2008, 102(6): 840-844.
20. 　Pinto-Plata VM, Müllerova H, Toso JF, et al. C-reactive protein in patients with COPD, control smokers and non-smokers[J]. Thorax, 2006, 61(1): 23-28.
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24. 　Donaldson GC, Seemungal TA, Patel IS, et al. Airway and systemic in?ammation and decline in lung function in patients with COPD[J]. Chest, 2005, 128(4): 1995-2004.
25. 　Mocchegiani E, Malavolta1 M, Costarelli L, et al. Zinc, metallothioneins and immunosenescence[J]. Proc Nutr Soc, 2010, 69(3): 290-299.
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  2. 2. 　Bai N, Khazaei M, van Eeden SF, et al. The pharmacology of particulate matter air pollution-induced cardiovascular dysfunction[J]. Pharmacol Ther, 2007, 113(1): 16-29.
  3. 3. 　Decramer M, Celli B, Tashkin DP, et al. Clinial trial design considerations in assessing long term functional impacts of tiotropium in COPD: the UPLIFT trial[J]. COPD, 2004, 1(2): 303-312.
  4. 4. 　Repine JE, Bast A, Lankhorst I. Oxidative stress in chronic obstructive pulmonary disease. Oxidative Stress Study Group[J]. Am J Respir Crit Care Med, 1997, 156(2 Pt 1): 341-357.
  5. 5. 　Sato M. Biological antioxidant defence system and metallotheionein[J]. Jpn J Toxicol Environ Health,1992, 38(3):228-239.
  6. 6. 　Viarengo A, Burlando B, Ceratto N, et al. Antioxidant role of metallothioneins: a comparative overview[J]. Cell Mol Biol, 2000, 46(2): 407-417.
  7. 7. 　Huang YL, Sheu JY, Lin TH. Association between oxidative stressand changes of trace elements in patients with breast cancer[J].Clin Biochem, 1999, 32(2): 131-136.
  8. 8. 　Tadzhiev FS. Trace elements in the pathogenesis and treatmentof chronic bronchitis (a clinico-experimental study) [J]. Ter Arkh, 1991, 63(3):68-70.
  9. 9. 　Karadag F, C?ldag O, Alt?n?s?k M, et al. Trace elements as a component of oxidative stress in COPD[J]. Respirology, 2004, 9(1):33-37.
  10. 10. 　Volanakis JE. Human C- reactive protein: expression, structure, and function[J]. Mol Immuno, 2001, 38(2-3): 189-197.
  11. 11. 　Wouters EF. Local and systemic inflammation in chronic obstructivepulmonary disease[J]. Proc Am Thorac Soc, 2005, 2(1): 26-33.
  12. 12. 　Rahman I, Macnee W. Oxidant/antioxidant imbalance in smokers and chronic obstructive pulmonary diseases[J]. Thorax, 1996, 51(4): 348-350.
  13. 13. 　Rahman I, Morrison D, Donaldson K, et al. Systemic oxidative stress in asthma, COPD, and smokers [J].Am J Respir Crit Care Med, 1996, 154(4 pt 1): 1055-1060.
  14. 14. 　Morrison D, Rahman I, Lannan S, et al. Epithelial permeability, in?ammation, and oxidant stress in the air spaces of smokers[J]. Am J Respir Crit Care Med, 1999, 159(2): 473-479.
  15. 15. 　Rahman I, Skwarska E, MacNee W. Attenuation of oxidant/antioxidant imbalance during treatment of exacerbations of chronic obstructive pulmonary disease[J].Thorax, 1997, 52(6): 565-568.
  16. 16. 　Quilliot D, Dousset B, Guerci B, et al. Evidence that diabetes mellitu favors impaired metabolism of zinc, copper and selenium in chronic pancreatitis[J]. Pancreatitis, 2001, 22(3):299-306.
  17. 17. 　Fabisiak JP, Tyurin VA, Tyurina YY, et al. Redox regulation of copper-metallothionein[J].Arch Biochem Biophys, 1999, 363(1): 171-181.
  18. 18. 　Rasad AS. Zinc in human health: an update[J]. Trace Elem Exp Med, 1998, 11(2-3): 63-87.
  19. 19. 　Kiril G, Hamdi Muz M, Seckin D, et al. Antioxidant effect of zinc picolinate in patients with chronic obstructive pulmonary disease[J]. Respir Med, 2008, 102(6): 840-844.
  20. 20. 　Pinto-Plata VM, Müllerova H, Toso JF, et al. C-reactive protein in patients with COPD, control smokers and non-smokers[J]. Thorax, 2006, 61(1): 23-28.
  21. 21. 　Dahl M, Vestbo J, Lange P, et al. C-reactive protein as a predictor of prognosis in chronic obstructive pulmonary disease[J]. Am J Respir Crit Care Med, 2007, 175(3): 250-255.
  22. 22. 　Schols AM, Buuman WA, Staal van den Brekel AJ, et al. Evidence for a relation between metabolic derangement s and increased levels of inflammatory mediators in a subgroup of patient s with chronic obstructive pulmonary disease[J].Thorax,1996, 51(8): 819-824.
  23. 23. 　Sin DD, Lacy P, York E, et al. Effects of fluticasone on systemic markers of inflammation in chronic obstructive pulmonary disease[J]. Am J Respir Crit Care Med, 2004, 170(7): 760-765.
  24. 24. 　Donaldson GC, Seemungal TA, Patel IS, et al. Airway and systemic in?ammation and decline in lung function in patients with COPD[J]. Chest, 2005, 128(4): 1995-2004.
  25. 25. 　Mocchegiani E, Malavolta1 M, Costarelli L, et al. Zinc, metallothioneins and immunosenescence[J]. Proc Nutr Soc, 2010, 69(3): 290-299.