慢性阻塞性肺疾病不同分期全身炎症与呼出气冷凝液炎症指标的变化及相互关系
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摘要
目的观察慢性阻塞性肺疾病不同分期全身炎症与呼出气冷凝液炎症指标的变化及探讨它们之间的关系。方法方便选取该院2016年6月—2017年12月收治的符合COPD诊断标准的患者30例为AECOPD组,另选择同期在该院行健康体检且无系统性疾病的健康志愿者30名作为健康对照组。收集急性发作期、缓解期患者的呼出气冷凝液,检测呼出气冷凝液和外周血清中白介素(IL-8)和肿瘤坏死因子a(TNF-a)的水平,并同时行肺功能检查。结果 AECOPD组患者血IL-8、血TNF-a、CRP、EBCIL-8、EBCTNF-a各项指标值分别为(69.53±25.23)pg/mL、(78.32±14.98)pg/mL、(78.73±13.45)mg/L、(15.32±3.17)pg/mL、(3.78±0.36)pg/mL,明显高于健康对照组水平,差异有统计学意义(t=26.321、32.624、54.126、18.332、6.104,P<0.05)。AECOPD组患者的肺功能各项指标低于对照组患者,且COPD急性加重患者经治疗后,外周血、呼出气冷凝液中IL-8和TNF-a均下降,差异有统计学意义(P<0.05)。结论 COPD急性加重期局部气道炎症和全身炎症反应与缓解期对比均明显增强,并可能加重了COPD患者的肺功能阻塞程度。
Objective To observe the changes of systemic inflammatorome of chronic obstructive pulmonary at different stages and Inflammatory index of exhaled breath condensate and its correlation.Methods 30 cases of patients meeting the COPD diagnosis standards in our hospital from June 2016 to December 2017 were conveniently selected as the AECOPD group,while 30 cases of healthy volunteers without the systematic diseases at the same period were selected as the healthy control group,and the exhaled breath condensate of patients during the acute attack period and relief period were collected,and the IL—8 and a(TNF-a) levels were tested,and the lung function was examined at the same period.Results The blood IL-8,blood TNF-a,CRP,EBCIL-8,EBCTNF-a of patients in the AECOPD group were respectively(69.53±25.23)pg/mL,(78.32±14.98)pg/mL,(78.73±13.45)mg/L,(15.32±3.17)pg/mL,(3.78±0.36)pg/mL,which were obviously higher than those in the healthy control group,the different was statistically significant(t=26.321,32.624,54.126,18.332,6.104,P<0.05),and various indicators of lung function in the AECOPD group were lower than those in the control group,and the IL-8 and TNF-a decreased in the peripheral blood and exhaled breath condensate,the different was statistically significant(P<0.05).Conclusion The local airway inflammation and systemic inflammatory response of patients during the COPD acute exacerbation stage obviously increase,and may aggravate the obstructive degree of the pulmonary function of COPD patients.
Objective To observe the changes of systemic inflammatorome of chronic obstructive pulmonary at different stages and Inflammatory index of exhaled breath condensate and its correlation.Methods 30 cases of patients meeting the COPD diagnosis standards in our hospital from June 2016 to December 2017 were conveniently selected as the AECOPD group,while 30 cases of healthy volunteers without the systematic diseases at the same period were selected as the healthy control group,and the exhaled breath condensate of patients during the acute attack period and relief period were collected,and the IL—8 and a(TNF-a) levels were tested,and the lung function was examined at the same period.Results The blood IL-8,blood TNF-a,CRP,EBCIL-8,EBCTNF-a of patients in the AECOPD group were respectively(69.53±25.23)pg/mL,(78.32±14.98)pg/mL,(78.73±13.45)mg/L,(15.32±3.17)pg/mL,(3.78±0.36)pg/mL,which were obviously higher than those in the healthy control group,the different was statistically significant(t=26.321,32.624,54.126,18.332,6.104,P<0.05),and various indicators of lung function in the AECOPD group were lower than those in the control group,and the IL-8 and TNF-a decreased in the peripheral blood and exhaled breath condensate,the different was statistically significant(P<0.05).Conclusion The local airway inflammation and systemic inflammatory response of patients during the COPD acute exacerbation stage obviously increase,and may aggravate the obstructive degree of the pulmonary function of COPD patients.
引文
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[8]董肖琦,沈茜,姚一楠,等.慢性阻塞性肺疾病急性加重患者呼出气冷凝液中白细胞介素-6与白三烯B4的检测及其临床意义[J].中华结核和呼吸杂志,2017,40(2):114-117.
[2]杨超勉,韦球,黄天霞,等.慢性阻塞性肺疾病治疗期间呼出气冷凝液中炎症因子的变化及临床意义[J].海南医学,2017,28(10):1611-1613.
[3]Barnes PJ.Inflammatory mechanisms in patients with chronic obstructive pulmonary disease[J].J Allergy Clin Immunol,2016,138(1):16-27.
[4]邓日强,杨印楼,谢斌,等.探讨检测老年慢性阻塞性肺疾病患者呼出气冷凝液中炎症因子水平的临床意义[J].泰山医学院学报,2015(12):1393-1394.
[5]张明华,余红樱,叶琳,等.慢性阻塞性肺疾病患者呼出气冷凝液中白三烯B4与肿瘤坏死因子α检测的临床意义[J].临床肺科杂志,2017,22(3):442-445.
[6]陈英吉.慢性阻塞性肺疾病合并肺动脉高压患者血清及呼出气冷凝液中炎症因子含量检测的临床意义[J].中国现代医学杂志,2015,25(12):61-64.
[7]晏斌林,顾为丽,杜娟,等.慢性阻塞性肺疾病患者呼出气冷凝液IL-17、IL-10、8-iso-PG的测定及临床意义[J].中国呼吸与危重监护杂志,2017(2):142-146.
[8]董肖琦,沈茜,姚一楠,等.慢性阻塞性肺疾病急性加重患者呼出气冷凝液中白细胞介素-6与白三烯B4的检测及其临床意义[J].中华结核和呼吸杂志,2017,40(2):114-117.