伴焦虑抑郁障碍的慢性阻塞性肺疾病急性加重期患者白介素8、肿瘤坏死因子α的临床研究  

Clinical research on interleukin-8 and tumor necrosis factor-α of patients with acute exacerbation of chronic obstructive pulmonary disease accompanied anxiety-depressive disorder

作　　者：姜静[1] 李迎利[1] 蒋德升[1] 蒋克春[1] 樊有[1] 顾晓燕[1] 陈小凤[1] 尚宁[1] 

机构地区：[1]解放军第454医院呼吸科,南京210002

出　　处：《国际呼吸杂志》2009年第15期901-904,共4页International Journal of Respiration

摘　　要：目的探讨伴有焦虑抑郁障碍的慢性阻塞性肺疾病急性加重期（acute exacerbation of chronic obstructive pulmonary disease，AECOPD）患者血清中自介素8（interukin-8，IL-8）、肿瘤坏死因子α（tumor necrosis factor-α，TNF-α）水平变化的关系。方法1999年3月至2004年3月在解放军第454医院呼吸科住院和门诊的患者，诊断为AECOPD患者35例，依照就诊的症状分组入选病例及随机分为两组，其中男21例，女14例；分别为焦虑抑郁障碍组和对照组（无焦虑抑郁障碍），两组分别为18例和17例。共观察2周。入院后及出院时观察咳嗽、咳痰、气喘、呼吸困难、胸闷、焦虑、抑郁障碍等症状，肺功能：第1秒用力呼气容积（FEV1）、FEV1占预计值百分比（FEV1pred％）测定及空腹静脉抽血用放射免疫法检测IL-8及TNF-α的含量。结果组间症状入院第1天（前）相比无明显差异，咳嗽、咳痰、呼吸困难、胸闷、焦虑、抑郁症状前与入院第14天（后）相比较，差异有统计学意义。两组治疗前后肺功能：FEV1、FEV1pred％指标前后差异无统计学意义。焦虑抑郁组前与后相比TNF—α含量降低差异有统计学意义，IL-8含量降低差异无统计学意义。结论伴有抑郁焦虑障碍AECOPD患者血清中IL-8及TNF-α含量增高，可能焦虑抑郁障碍是AECOPD的危险因素之一，与病变过程中炎症因子的溢出有关，其机制有待进一步研究。Objective To explore the change of serum interleukin-8（IL-8） and tumor necrosis factor-α （TNF-α） of patients with acute exacerbation of chronic obstructive pulmonary disease （AECOPD） accompanied with anxiety-depressive disorder, Methods Thirty-five patients （21 male and 14 female） in the hospital diagnosed AECOPD during March 1999 and March 2004 were randomly divided into two groups, anxiety-depressive disorder group and no anxiety-depressive disorder group. Observation time was two weeks. Observed symptoms included cough, expectoration, asthma, dyspnea, chest distress, anxiety and depressive disorder and others. Lung function was observed, too. Level of serum IL-8 and TNF-α were detected by radio-immunity method. Results Difference of symptoms between two groups had no statistic significance before therapy（lst day after admission）. After therapy（14th day after admission）, difference of some symptoms （cough, expectoration, dyspnea, chest distress, anxiety and depressive disorder） between two groups had statistic significance. Difference of lung function of two groups between before and after therapy had no statistic significance. TNF-a showed significant difference in its concentration decrease between before and after therapy in anxiety-depressive disorder group,but IL-8 was of no significant decrease. Conclusions Level of serum IL-8 and TNF-α increased in patients with AECOPD accompanied with anxiety-depressive disorder. Anxiety-depressive disorder may be one of dangerous factors of AECOPD. It is related with overflowing of inflammatory factor during the disease. Mechanism will be researched more in future.

关 键 词：肺疾病 阻塞性 焦虑抑郁 白介素8 肿瘤坏死因子Α 

分 类 号：R563.9[医药卫生—呼吸系统]