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目的研究慢性阻塞性肺疾病(COPD)患者支气管黏膜中过氧化物酶增殖物激活受体-γ(PPAR-γ)、基质金属蛋白酶-9(MMP-9)和诱生型一氧化氮合酶(iNOS)的表达及与气流阻塞的关系。方法根据吸烟史及肺功能检查将其受试者分为3组:吸烟伴COPD患者18例;吸烟肺功能正常组15例;不吸烟肺功能正常组15例。全部受试者经电子支气管镜取支气管黏膜标本,采用免疫组织化学法检测支气管黏膜中核转录因子PPAR-γ、MMP-9和iNOS的表达,并进行相关性分析。结果①免疫组织化学染色结果:核转录因子PPAR-γ在吸烟伴COPD组和吸烟肺功能正常组表达明显减少,MMP-9和iNOS在两组表达明显增多,与不吸烟肺功能正常组比较差异均有统计学意义(P<0.01);②相关性分析:核转录因子PPAR-γ的表达与FEV1%、FEV1/FVC%呈直线正相关(P<0.01);MMP-9和iNOS的表达与肺功能指标呈直线负相关(P<0.01)。COPD患者支气管黏膜中核转录因子PPAR-γ的表达与MMP-9和iNOS的表达均呈直线负相关(P<0.05)。结论COPD患者支气管黏膜中核转录因子PPAR-γ表达减少导致气道的抗炎能力下降,气道内炎症细胞及炎症介质增多,导致肺组织损伤及重构,引起和加重COPD患者的气流阻塞。
Objective To investigate the expression of peroxisome proliferator - activated receptor - γ (PPAR - γ), matrix metalloproteinase - 9 (MMP - 9) and inducible nitric oxide synthase in bronchial mucosa of patients with chronic obstructive pulmonary disease (COPD) (iNOS) expression and airflow obstruction. Methods According to the smoking history and pulmonary function tests, the subjects were divided into three groups: 18 patients with COPD smoked cigarettes; 15 patients with normal lung function; 15 patients with normal lung function without smoking. Bronchial mucosa specimens were taken from all the subjects by electron bronchoscopy. The expression of nuclear transcription factors PPAR-γ, MMP-9 and iNOS in bronchial mucosa were detected by immunohistochemistry and the correlation was analyzed. Results ①Immunohistochemical staining results: The expression of PPAR-γ was significantly decreased in smoking-associated COPD patients and smoking lungs, and the expressions of MMP-9 and iNOS in both groups were significantly increased compared with non-smoking lung function normal group (P <0.01). (2) Correlation analysis: There was a linear positive correlation between the expression of nuclear transcription factor PPAR-γ and FEV1% and FEV1 / FVC% (P <0.01) Lung function was negatively correlated (P <0.01). The expression of nuclear transcription factor PPAR-γ in bronchial mucosa of COPD patients was negatively correlated with the expression of MMP-9 and iNOS (P <0.05). Conclusion The decreased expression of nuclear transcription factor PPAR-γ in bronchial mucosa of COPD patients leads to decreased airway anti-inflammatory ability, increased inflammatory cells and inflammatory mediators in the airway, resulting in lung injury and remodeling, causing and obstructive airflow obstruction in COPD patients.