慢性阻塞性肺疾病患者体内白介素-6和C反应蛋白质量浓度的变化及意义  

Levels of interleukin-6 and CRP in patients with chronic obstructive pulmonary disease and its significance

作　　者：何智辉[1] 陈平[2] 

机构地区：[1]中南大学湘雅二医院ICU中心,湖南长沙410011 [2]中南大学湘雅二医院呼吸内科,湖南长沙410011

出　　处：《中国实用内科杂志》2006年第7期989-991,共3页Chinese Journal of Practical Internal Medicine

摘　　要：目的观察慢性阻塞性肺疾病(COPD)患者体内白介素-6(IL-6)和C反应蛋白(CRP)的质量浓度变化及其与气流受限、急性发作是否相关。方法同步收集中南大学湘雅二医院2004年2月至7月54例COPD稳定期患者和10名健康对照者的诱导痰和空腹静脉血,测定诱导痰上清液和血清中的IL-6和CRP质量浓度,进行比较。结果(1)COPD各组痰IL-6均较正常对照组显著增高(P<0.01),血清IL-6在COPDⅢ级、Ⅳ级较正常对照组显著增高(P<0.05),COPD患者痰IL-6显著高于自身血清IL-6(P<0.01);COPDⅡ级、Ⅲ级和Ⅳ级痰CRP较正常对照组显著增高(P<0.01),COPDⅢ级和Ⅳ级血清CRP较正常对照组显著增高(P<0.01),COPD患者血清CRP显著高于自身痰CRP质量浓度(P<0.01)。(2)痰IL-6与肺功能气流受限指标第1秒用力呼气容积占预计值百分比(FEV1%)、第1秒用力呼气容积占用力肺活量百分比(FEV1/FVC%)呈负相关。痰IL-6和CRP与急性发作次数呈正相关。结论IL-6和CRP参与了稳定期COPD患者气道慢性炎症;重度气流受限的稳定期COPD患者体内存在系统性炎症反应;痰IL-6含量有助于预测COPD患者急性发作频率。Objective To investigate IL -6 and CRP levels, and their relationship with airflow obstruction, frequency of exacerbation in patients with COPD. Methods From Feb, 2004 to Jul. 2004, sputum and serum specimens were obtained from 54 patients with stable COPD and 10 age - matched healthy controls, The concentrations of sputum IL - 6 and serum IL -6 were measured by ELISA, The concentrations of sputum CRP and serum CRP were measured by trans- missive heterometfic titration, Results （ 1 ） Sputum IL - 6 levels in COPD patients of all stages were higher than those in controls （P 〈0. 01 ）. Serum IL-6 levels in stageⅢ and stageⅣ COPD patients were higher than those in controls （P 〈0. 05）. Sputum IL-6 levels were higher than serum IL-6 levels in COPD patients （P 〈0. 01）. Sputum CRP levels in stage Ⅱ, Ⅲ, Ⅳ COPD patients were higher than those in controls （ P 〈 0.01 ）. Serum CRP levels in stage Ⅲ, Ⅳ COPD patients were higher than those in controls （P 〈 0.01 ）. Serum CRP levels were higher than sputum CRP levels in COPD patients （P 〈 0. 01 ）. （2） Sputum IL- 6 level was inversely correlated with FEV1 % and FEV1/ FVC%. Sputum IL -6 and CRP levels were positively correlated with the frequency of exacerbations. Conclusion IL - 6 and CRP may be involved in the chronic airway inflammatory process in stable COPD. Systemic inflammatory process is present in stable COPD patients with severe airflow obstruction. Sputum IL - 6 level may predict the frequency of exacerbation in COPD patients.

关 键 词：肺疾病 慢性阻塞性 诱导痰 气流受限 白介素-6 C反应蛋白 

分 类 号：R5[医药卫生—内科学]