肺部感染对慢性阻塞性肺疾病患者呼吸功能状态与细胞因子表达的影响  

Effects of pulmonary infection on respiratory function and cytokine expression in patients with chronic obstructive pulmonary disease

作　　者：徐慧[1] 赵登峰[1] 王淼 丁锋[1] 李媛媛 XU Hui;ZHAO Deng-feng;WANG Miao;DING Feng;LI Yuan-yuan(First Affiliated Hospital of Nan yang Medical College , Nanyang , Henan 473058, China)

机构地区：[1]南阳医学高等专科学校第一附属医院呼吸内科,河南南阳473058

出　　处：《中华医院感染学杂志》2019年第7期1011-1014,共4页Chinese Journal of Nosocomiology

基　　金：河南省医学科技攻关计划基金资助项目(201503012)

摘　　要：目的探讨肺部感染对慢性阻塞性肺疾病(COPD)患者呼吸功能状态与细胞因子水平的影响。方法2016年1月-2018年1月医院收治的COPD合并肺部感染患者54例作为试验组,COPD无肺部感染患者50例作为对照组。采用酶联免疫吸附试验检测细胞因子白细胞介素-6(IL-6)、白细胞介素-8(IL-8)、肿瘤坏死因子-α(TNF-α)和转化生长因子-β(TGF-β)的水平,使用肺功能检测仪检测患者第一秒末用力呼气量(FEV1)、每分钟最大通气量(MVV)、最大呼气中期流速(MMF)、气道阻力(RAW)、共振频率(Fres)、动态胸肺顺应性(Cdyn)呼吸功能指标。结果试验组血清IL-6、IL-8、TNF-α和TGF-β的水平分别为(11.0±0.8)(pg/ml)、(11.3±1.1)(pg/ml)、(1.8±0.1)(ng/L)、(98.2±6.4)(ng/L),均高于对照组,试验组FEV1、MVV、MMF和Cdyn分别为(61.5±5.0)%、(46.5±3.9)%、(0.8±0.1)L/s、(30.8±5.4)ml/cmH2O,均低于对照组,试验组RAW和Fres分别为(118.3±12.4)%、(22.6±5.4)Hz,均高于对照组(P<0.05);感染程度越高,患者血清IL-6、IL-8、TNF-α和TGF-β的水平越高,FEV1、MVV、MMF和Cdyn越低,而RAW和Fres越高(P<0.05)。结论肺部感染影响了COPD患者的肺功能和炎症细胞因子水平,临床上应注重控制和预防肺部感染。OBJECTIVE To investigate the effects of pulmonary infection on respiratory function and cytokine expression in patients wilh chronic obstructive pulmonary disease (CODP). METHODS Fifty-four patients with COPD combined with pulmonary infection in our hospital from Jan. 2016 to Jan. 2018 were included in this study as the observation group, and another 50 patients with COPD and without pulmonary infection were included as the control group. Enzyme-linked immunosorbent assay (ELISA) was used to detect cytokines levels of interleukin (IL)-6, IL-8, tumor necrosis factor (TNF)-a and transforming growth factor (TGF)-β. The pulmonary function detector was used to determine the respiratory function indexes such as forced expiratory volume at the end of the first second (FEVi ), per minute ventilation volume (MVV), maximal mid expiratory flow (MMF), airway resistance (RAW), resonance frequency (Fres) and dynamic lung compliance (Cdyn). RESULTS The serum levels of IL-6(11.0±0.8)pg/ml, IL-8(11.3± l.l)pg/ml, TNF-α(1.8±0.l)ng/L and TGF-β(98.2 ± 6.4)ng/L levels in the observation group were significantly higher than those in the control group(P <0.05);FEV1(61.5± 5.0)%, MVV(46.5± 3.9)%, MMF(0.8±0.1)L/s and Cdyn(30.8±5.4)ml/cmH2 O in the observation group were significantly lower than those in the control group (P<0.05). RAW( 118.3± 12.4)% and Fres(22.6±5.4) Hz in the observation group were significantly higher than those in the control group (P<0.05). The higher the infection degree, the higher the serum IL 6, IL-8, TNF-α and TGF-β levels were (P<0.05). The higher the infection degree, the lower the FEV1, MVV, MMF and Cdyn, and the higher the RAW and Fres were (P<0.05). CONCLUSION Pulmonary infection significantly affects the lung function and inflammatory cytokine levels in the patients with chronic obstructive pulmonary disease. In clinic, we should pay attention to control and prevent pulmonary infection.

关 键 词：感染 慢性阻塞性肺疾病 肺功能 细胞因子 

分 类 号：R563.1[医药卫生—呼吸系统]