稳定期慢性阻塞性肺疾病患者血浆及诱导痰中炎性因子水平变化  

Levels of inflammatory cytokines in plasma and induced sputum in patients with stable chronic obstructive pulmonary disease

作　　者：梁杨丽 毛兵[2] LIANG Yangli;MAO Bing(Grade 2015,West China School of Medicine of Sichuan University,Chengdu 610041,China)

机构地区：[1]四川大学华西临床医学院,2015级成都610041 [2]华西医科大学附属第一医院中西医结合科,成都610041

出　　处：《中华实用诊断与治疗杂志》2018年第11期1087-1090,共4页Journal of Chinese Practical Diagnosis and Therapy

基　　金：四川省科技厅支撑计划项目(2015SZ0130);四川省科技厅支撑计划项目(2013SZ0001-5);四川省人事厅学术带头人培育基金(川财社[2014]120号)

摘　　要：目的探讨稳定期慢性阻塞性肺疾病(chronic obstructive pulmonary disease,COPD)患者血浆及诱导痰中炎性因子水平的变化及意义。方法稳定期COPD患者201例为COPD组,根据改良呼吸困难指数(modified British Medical Research Council,mMRC)评分、COPD评估测试(COPD assessment test,CAT)评分、急性加重发作次数分为4个亚组,A组11例(mMRC评分为0～1级,CAT评分<10分,急性加重发作次数0～1次),B组33例(mMRC≥2级,CAT评分≥10分,急性加重发作次数0～1次),C组32例(mMRC评分为0～1级,CAT评分<10分,急性加重发作次数≥2次),D组125例(mMRC评分≥2级,CAT评分≥10分,急性加重发作次数≥2次);同期体检健康者50例为对照组。比较各组一般资料,检测各组血浆及诱导痰中白细胞介素(interleukin,IL)-1β、IL-6、IL-8、肿瘤坏死因子-α(tumor necrosis factor-α,TNF-α)、高敏C反应蛋白(high-sensitivity C-reactive protein,hs-CRP)水平。结果 COPD组血浆IL-6、IL-8、TNF-α水平均高于对照组(P<0.05);D组血浆IL-6[(2.61±1.16)ng/L]、IL-8[(16.56±5.52)ng/L]、hs-CPR[(1 862.26±578.39)mg/L]、TNF-α[(373.39±136.24)nmol/L]水平高于C组[(2.07±0.83)ng/L、(14.06±7.26)ng/L、(1 736.19±548.37)mg/L、(380.01±128.65)nmol/L]、B组[(1.87±0.62)ng/L、(12.13±4.70)ng/L、(1 636.54±449.45)mg/L、(301.17±134.60)nmol/L]和A组[(1.69±0.43)ng/L、(9.09±2.57)ng/L、(1 602.34±390.26)mg/L、(258.14±49.48)nmol/L](P<0.05),C组高于B组和A组(P<0.05);COPD组诱导痰IL-6、IL-8、hs-CRP、TNF-α和IL-1β水平均高于对照组(P<0.05);D组诱导痰IL-6[(289.46±131.25)ng/L]、IL-8[(1 409.29±446.95)ng/L]、hs-CRP[(3 614.89±723.25)mg/L]、TNF-α[(1 212.25±247.37)nmol/L]高于C组[(209.39±131.38)ng/L、(921.72±359.77)ng/L、(3 291.68±630.75)mg/L、(779.77±213.75)nmol/L]、B组[(194.29±77.29)ng/L、(966.63±318.65)ng/L、(3 219.12±762.31)、(1 191.50±362.56)nmol/L]和A组[(147.16±32.68)、(894.78±278.33)、(3 139.95±605.17)、(780.20±396.38)nmol/L](P<0.05);A、B、C、D组诱�Objective To investigate the changes and significances of inflammatory cytokines in plasma and induced sputum in patients with stable chronic obstructive pulmonary disease（COPD）.Methods According to the modified British Medical Research Council（mMRC）score,COPD assessment test（CAT）score test results and acute aggravation onset frequency,201 patients with stable COPD（COPD group）were divided into 4 subgroups,group A（mMRC：0-1,CAT10,acute aggravation onset frequency：0-1,n=11）,group B（mMRC≥2,CAT≥10,acute exacerbation onset frequency：0-1,n=33）,group C（mMRC：0-1,CAT10,acute aggravation onset frequency≥2,n=32）,and group D（mMRC≥2,CAT≥10,acute exacerbation onset frequency≥2,n=125）.Another 50 healthy volunteers were as controls（control group）.ELISA was used to detect the levels of interleukin（IL）-1β,IL-6,IL-8,tumor necrosis factor-α（TNF-α）and high-sensitivity C-reactive protein（hs-CRP）in plasma and induced sputum.Results The plasma levels of IL-6,IL-8 and TNF-αwere significantly higher in COPD group than those in control group（P0.05）.The plasma levels of IL-6,IL-8,hs-CRP and TNF-αwere significantly higher in group D（（2.61±1.16）ng/L,（16.56±5.52）ng/L,（1 862.26±578.39）mg/L,（373.39±136.24）nmol/L）than those in group C（（2.07±0.83）ng/L,（14.06±7.26）ng/L,（1 736.19±548.37）mg/L,（380.01±128.65）nmol/L）,group B（（1.87±0.62）ng/L,（12.13±4.70）ng/L,（1 636.54±449.45）mg/L,（301.17±134.60）nmol/L）and group A（（1.69±0.43）ng/L,（9.09±2.57）ng/L,（1 602.34±390.26）mg/L,（258.14±49.48）nmol/L）（P0.05）,and in group C than those in group B and A（P0.05）.The levels of IL-6,IL-8,hs-CRP,TNF-αand IL-1βin sputum were significantly higher in COPD group than those in control group（P0.05）.The levels of IL-6,IL-8,hs-CRP and TNF-αin sputum were significantly higher in group D（（289.46±131.25）ng/L,（1 409.29±446.95）ng/L,（3 614.89±723.25）mg/L,（1 212.25±247.37）nmol/L）tha

关 键 词：慢性阻塞性肺疾病 改良呼吸困难指数 慢性阻塞性肺病评估测试评分 

分 类 号：R563.9[医药卫生—呼吸系统]