前列地尔对慢性阻塞性肺疾病合并肺动脉高压患者呼气冷凝液中内皮素-1、白介素-6的影响  

Influence of Lipo PGE1 on ET-1 and IL-6 in exhaled breath condensate of patients with chronic obstructive pulmonary disease and pulmonary hypertension

作　　者：李婕[1] 赵磊[1] 

机构地区：[1]安徽医科大学第二附属医院呼吸内科,合肥230601

出　　处：《安徽医科大学学报》2017年第6期892-896,共5页Acta Universitatis Medicinalis Anhui

基　　金：安徽高校自然科学研究项目(编号:KJ2016A359)

摘　　要：目的探讨前列地尔脂微球载体制剂(Lipo PGE1)对慢性阻塞性肺疾病(COPD)合并肺动脉高压(PH)患者呼出气冷凝液(EBC)中内皮素(ET-1)和白介素(IL-6)的影响及其临床意义。方法选择40例COPD合并PH患者,随机分为治疗组和对照组,每组20例。对照组予以抗炎、解痉、平喘、化痰、吸氧等常规治疗;治疗组在常规治疗基础上加用Lipo PGE1(10μg/d,静脉滴注,疗程10 d)。观察两组患者治疗前后EBC中ET-1和IL-6浓度、肺动脉收缩压(PASP)、动脉血PaO_2、PaCO_2、肺功能FEV_1/FVC、FEV_1/预计值等相关指标情况。结果治疗前两组患者PASP,EBC中ET-1、IL-6浓度,动脉血PaO_2、PaCO_2,肺功能FEV_1/FVC、FEV_1/预计值等相关指标差异均无统计学意义;治疗后治疗组EBC中ET-1、IL-6浓度、PASP、动脉血PaCO_2水平均低于对照组(P<0.05);动脉血PaO_2、肺功能FEV_1/FVC、FEV_1/预计值水平均高于对照组(P<0.05);两组患者EBC中ET-1、IL-6水平均与PASP呈正相关性(r=0.672、0.496,P<0.01)。结论Lipo PGE1可以降低COPD合并PH患者EBC中的ET-1、IL-6水平,EBC中ET-1、IL-6可做为COPD合并PH疗效判断指标,具有一定临床意义。Objective To explore the influence of Lipo PGE1 on endothelin （ET-1） and interleukin （IL-6） inexhaled breath condensate（EBC） of patients with chronic obstructive pulmonary disease （COPD） and pulmonary hypertension（PH） and its clinical significance. Methods A total of 40 cases of patients with COPD and PH were randomly divided into thecontrol group and the treatment group,20 cases in each group. The control group was ad- ministered with the conventional treatments such as anti-infection, bronchodilator, antiasthma, expectorant and ox- ygen therapy; the treatment group was administered with Lipo PGE! （10 Ixg/d, iv, for 10 days） besides the con- ventional treatments. ET-1 and IL-6 in EBC, pulmonary artery systolic pressure （ PASP）, arterial blood PaO2 and PaCO2, lung function FEVJFVC, FEV1% pred in both groups were assayedbefore and after the treatment. Results There were no statistical difference between the two groups in the ET-1 and IL-6 in EBC, PASP, arterial blood PaO2 and PaCO2,FEVI/FVC, FEV~% pred before the treatment. After the treatment, the ET-1, IL-6 in EBC, PASP and arterial blood PaCO2 of the treatment group were lower than thoseof the control group （P 〈 0.05 ） ; the arterial blood PaO2, FEVJFVC, FEV1% pred of the treatment group were higher than those of the control group （P 〈0.05 ） ;The levels of ET-1 and IL-6 in EBC wereboth positivelycorrelated with PASP in the two groups. Con- clusion Lipo PGE1 can reduce the levels of ET-1 and IL-6 in EBC of patients with COPD and PH. ET-1 and IL- 6 may become a curative effect judgment index of COPD and PH, which has a certain clinical significance.

关 键 词：慢性阻塞性肺疾病 肺动脉高压 前列地尔脂微球载体制剂 呼出气冷凝液 内皮素-1 白介素-6 

分 类 号：R563.9[医药卫生—呼吸系统] R541.5[医药卫生—内科学]