The Role Of Endogenous Hydrogen Sulfide And Reactive Oxygen Species In Chronic Obstructive Pulmonary Disease

Objective To observe the changes of serum Hydrogen sulfide?H2S?,Reactive Oxygen Species?ROS?and Nuclear Factor-?B?NF-?B?in patients with acute exacerbation of Chronic Obstructive Pulmonary Disease?AECOPD?,and to explore its clinical significance.Methods A total of 60 patients with AECOPD were enrolled in the Department of Respiratory Medicine,Renmin Hospital of Ningxia Hui Autonomous Region,November 2015,according to the GD classification criteria,according to the severity of COPD,: Grade 26 patients in 26 cases,III patients in 24 cases,IV patients in 10 cases),According to the Chinese Medical Association Respiratory Diseases Branch promulgated the "Guidelines for the Diagnosis and Treatment of Chronic Obstructive Pulmonary Disease" 2013 revision diagnostic criteria into the group.The control group selected 60 healthy subjects in the physical examination center of our hospital.The age,sex,body mass index and smoking index were matched between the two groups.AECOPD patients were divided into two groups before and after treatment.After treatment group definition: 60 patients with AECOPD group given oxygen,anti-infection,antispasmodic asthma and other consistent conventional treatment?not including the use of vitamins?,symptom relief to discharge standards for the treatment group.According to the results of echocardiography at admission?pulmonary artery systolic pressure?PASP?> 50 mmHg for pulmonary hypertension?,COPD combined with pulmonary hypertension and COPD non-pulmonary hypertension group.The levels of serum H₂S,ROS and NF-?B in patients with AECOPD before and after treatment were measured by enzyme-linked immunosorbent assay?ELISA?,FEV1%,Pulmonary artery systolic pressure?PASP?,six-minute walking test?6MWT?,improved dyspnea score?MMRC?,and PaCO2,PaO₂,Blood routine white blood cell count?WBC?,neutrophil absolute value?GRA?and high sensitivity C-reactive protein?CRP?were analyzed.Results1.There was no significant difference in age,sex and body mass index between healthy control group and AECOPD group?P>0.05?.FEV1/FVC in AECOPD group was significantly lower than that in normal control group?P <0.05?.2.Changes of serum levels of H₂S,ROS and NF-?B in the three groups before and after AECOPD treatment and normal control group:?1?AECOPD ROS levels were significantly increased:Serum levels of ROS?569.74 ± 73.97?IU/ml were measured before treatment and?396.93±83.40?IU/ml?P<0.05?after treatment with AECOPD;Normal control group?285.01± 68.89?IU/ml?P<0.05?;?2?AECOPD levels of NF-?B were significantly increased:The levels of serum NF-?B?15.77±2.03?ng/ml in group AECOPD were significantly higher than those before treatment?12.88±2.50?ng/ml?P<0.05?;?8.56±2.43?ng/ml?P<0.05?in the normal control group;?3?AECOPD H₂S levels were significantly reduced:The serum levels of H2S?19.72 ± 3.99?nmol/ml were measured before treatment with AECOPD group?24.37±7.32?nmol/ml?P<0.05?;Normal control group?38.17±4.63?nmol/ml?P<0.05?.3.Sub-layer analysis:?1?According to GOLD pulmonary function grade,grade II,III and IV ROS values were?521.35 ± 57.71?IU/ml,?561.88±53.44?IU/ml,?658.96±34.80?IU/ml,Gradually increased trend?P<0.05?;NF-?B values were?15.16±2.30?ng/ml,?15.92±1.57?ng/ml,?16.62±1.91?ng/ml,Gradually increased trend;H2S values were?22.20±3.22?nmol/ml,?19.73±3.38?nmol/ml,?15.28±1.65?nmol/ml,and gradually decreased?P<0.05?;?2?According to whether the merger HP showed AECOPD combined with HP group compared with AECOPD non-combined HP group ROS significantly increased??611.34±70.81?IU/ml,?543.89±64.12?IU/ml,P <0.05?;NF-?B was significantly increased?16.69±1.64?ng/ml,?15.20±2.05 ng/ml,P<0.05?;H2S was significantly decreased?17.51±3.57 nmol/ml,?21.09±3.04?nmol/ml,P <0.05?.4.Correlation analysis:?1?Serum H₂S was positively correlated with FEV1% predict ed,PaO₂,6MWT?r=0.605,0.759,0.755,P<0.05?;and there were negatively correlated w ith PASP,MMRC,WBC,GRA,CRP?R=-0.436,-0.516,-0.261,-0.266,-0.268,P<0.05?.Serum RO S was negatively correlated with FEV1% predicted,6MWT,PaO₂?r=-0.698,-0.676,-0.896,P<0.05?;and there was a positive correlation with PASP,MMRC,WBC,GRA and CRP?R = 0.477,0.463,0.318,0.316,0.329,P<0.05?.There was a negative correlation between s erum NF-?B and FEV1% predicted and PaO₂?r=-0.330,-0.344,P<0.05?;and there was a positive correlation with PASP,MMRC,WBC,GRA and CRP?R=0.283,0.266,0.519,0.516,0.566,P <0.05?.5.There was a negative correlation between serum H₂S and ROS and NF-?B in COPD group?r=-0.87,-0.281,P <0.05?,Serum ROS was positively correlated with NF-?B?r= 0.356,P <0.05?.Conclusion1.Endogenous H₂S,ROS may play an important role in the oxidative stress mechanism of COPD and COPD-related PH.2.ROS may produce oxidative stress injury through NF-?B in AECOPD,and endogenous H₂S may reduce its damage by inhibiting ROS and NF-?B activation.3.Endogenous H₂S,ROS and COPD acute exacerbations,the severity of the disease is closely related to the severity of the disease can be used as an evaluation index.