IL-18、IL-13和TNF-α在慢性阻塞性肺疾病中的变化及意义  

Changes and significance of IL-18,IL-13 and TNF-α in chronic obstructive pulmonary disease

作　　者：陈庆芸[1] 谢灿茂[2] 黄白丽[3] 吴海弟[1] 黄奕江[1] 

机构地区：[1]海南省人民医院呼吸内科,海南海口570311 [2]中山大学附属第一医院呼吸内科,广东广州510080 [3]海南省人民医院中心试验室,海南海口570311

出　　处：《中国现代医学杂志》2011年第22期2796-2799,共4页China Journal of Modern Medicine

摘　　要：目的探讨IL-18、IL-13和TNF-α在慢性阻塞性肺疾病(COPD)中的变化及意义。方法通过酶联免疫吸附法测定15例健康对照者和39例COPD患者急性加重期及缓解期诱导痰和血清中IL-18、IL-13和TNF-α的浓度,研究IL-18、IL-13和TNF-α与肺通气功能和体重指数的相关关系。结果 COPD患者缓解期血清和诱导痰中IL-18和TNF-α的水平较健康对照组升高(P<0.05);急性加重期血清和诱导痰中TNF-α和IL-13的水平较缓解期升高(P<0.05);缓解期血清和诱导痰中IL-18的水平与FEV1呈负相关(r=-0.703;r=-0.647);急性加重期诱导痰中IL-13的水平与FEV1呈负相关(r=-0.385);缓解期的血清和诱导痰中和急性加重期的血清中IL-18的水平与BMI呈负相关(r=-0.334;r=-0.359;r=-0.584)。结论 IL-18和TNF-α等多种细胞因子介导的气道炎症与全身炎症是COPD的发病机制之一;IL-13可能是急性加重期肺功能急剧下降更重要的细胞因子;IL-18可能参与COPD营养不良的发生。【Objective】 To explore the changes and significance of IL-18,IL-13 and TNF-α in chronic obstructive pulmonary disease（COPD）.【Methods】 39 patients with COPD and 15 control subjects were enrolled in the study.To survey the induced sputum and serum concentration of IL-18,IL-13 and TNF-α in the acute exacerbation and stable phase of COPD by enzyme linked immunosorbent assay.To compare the correlation among the cytokines,pulmonary ventilation capability and body mass index in COPD.【Results】 Serum and induced sputum concentration of IL-18 and TNF-α in stable phase of COPD were significantly higher than that in control group（P 0.05）.Serum and induced sputum concentration of TNF-α and IL-13 in acute phase were significantly higher that in stable phase（P 0.05）.The level of IL-18 in serum and induced sputum in stable phase were negatively correlated with FEV1（r =-0.703;r =-0.647）.The level of IL-13 in induced sputum in acute phase was negatively correlated with FEV1（r =-0.385）.The level of IL-18 in serum and sputum in stable phase and that in serum in acute phase were negatively correlated with BMI（r =-0.334;r =-0.359;r =-0.584）.【Conclusions】 Airway inflammation and systemic inflammation mediated by many kinds of cytokines which including IL-18 and TNF-α were one of pathogenesis of COPD.IL-13 might be the prior cytokine in acute exacerbation of COPD when pulmonary function rapid breakdown.IL-18 might participate in the mechanism of malnutrition in COPD.

关 键 词：慢性阻塞性肺疾病 白介素-18 白介素-13 肿瘤坏死因子-α 体重指数 肺通气功能 诱导痰 

分 类 号：R563.3[医药卫生—呼吸系统]