COPD急性加重期和稳定期血清炎性因子水平及其与肺功能的关系  

Correlation between Level of Serum Inflammatory Factors and Pulmonary Function in Patients with Acute Exacerbation and Stable Stage of COPD

作　　者：孙世民[1] 张珠[1] 王云雀[1] 

机构地区：[1]武汉理工大学医院内科,湖北省武汉市430070

出　　处：《中国全科医学》2014年第24期2790-2793,共4页Chinese General Practice

摘　　要：目的探讨COPD急性加重期和稳定期血清炎性因子水平变化及其与肺功能的关系。方法收集我院2010年3月—2013年9月呼吸内科确诊的COPD患者450例,依据其临床阶段分为急性加重期(207例)和稳定期(243例),并以本院体检科体检健康者100例为对照组,比较各组炎性因子水平、肺功能指标,肺功能分级与炎性因子的关系采用多分类Logistic回归分析。结果与对照组比较,稳定期COPD患者白介素(IL)-2降低,干扰素γ(IFN-γ)、结缔组织生长因子(CTGF)升高,急性加重期COPD患者IL-1β、IL-8、肿瘤坏死因子α(TNF-α)、IFN-γ、CTGF升高,IL-2降低(P<0.05);与稳定期比较,急性加重期COPD患者IL-1β、IL-8、TNF-α、IFN-γ和CTGF升高,IL-2降低(P<0.05)。稳定期和急性加重期COPD患者较对照组一秒用力呼气容积(FEV1)、FEV1/用力肺活量(FVC)和FEV1占预计的百分比值降低(P<0.05);急性加重期较稳定期COPD患者FEV1、FEV1/FVC和FEV1占预计值的百分比降低(P<0.05)。多分类Logistic回归分析结果显示,IL-1β、IL-2、IL-8、TNF-α、IFN-γ和CTGF与肺功能有回归关系(P<0.05)。结论 IL-1β、IL-8、TNF-α、IFN-γ和CTGF升高是COPD急性加重的主要指标,对指导临床治疗COPD和其严重程度的判断有一定意义。Objective To explore the correlation between level of serum inflammation factors and pulmonary function in patients with acute exacerbation and stable stage of COPD. Methods From March 2010 to September 2013 , patients with COPD who were diagnosed in department of respiratory internal medicine of our hospital were selected as study subjects. According to the clinical stage,the patients was divided into acute exacerbation group（207 cases）and stable stage group（243 cases）, 100 healthy people from department of health examination were selected as control group. The levels of inflammatory factors and pulmonary function examination indicators were compared among various groups,and multinomial Logistic regression analysis were performed to identify the correlation between level of serum inflammation factors and pulmonary function. Results Compared with the control group,the levels of IL-2 in stable stage group decreased,the levels of IFN- γand CTGF in stable stage group in-creased（P〈0. 05）. Compared with stable stage group,the levels of IL-1β,IL-8,TNF- α,IFN- γand CTGF in acute exacerbation group increased,the levels of IL-2 in acute exacerbation group decreased（P〈0. 05）. FEV1,FEV1/FVC and FEV1/ expected value in stable stage group and acute exacerbation group were significantly lower than those in control group（ P〈0. 05）. FEV1 ,FEV1/FVC and FEV1/ expected value in acute exacerbation group were significantly lower than those in stable stage group（P〈0. 05）. Multiple Logistic regression analysis results showed that there was a marked regression relationship be-tween levels of IL-1 β,IL-2,IL-8,TNF-α,IFN- γ,CTGF and pulmonary function（P〈0. 05）. Conclusion The increased levels of IL-1β,IL-8,TNF-α,IFN-γ and CTGF may be the main markers for acute exacerbation of COPD, which could guide the clinical treatment of COPD and have certain significance in judging the severity of COPD.

关 键 词：肺疾病 慢性阻塞性 白介素类 干扰素类 呼吸功能试验 

分 类 号：R563[医药卫生—呼吸系统]