COPD、支气管哮喘、哮喘-COPD重叠综合征患者血清TNF-α、IL-17和IL-18水平与肺功能参数的关系研究  

The Relationship between Serum TNF-α,IL-17 and IL-18 Levels and Lung Function Parameters in Patients with COPD,Bronchial Asthma and Asthma-COPD Overlap Syndrome

作　　者：张树伟 ZHANG Shuwei(Mengyin People's Hospital,Mengyin 276299,China)

机构地区：[1]山东省蒙阴县人民医院,山东蒙阴276299

出　　处：《中国医药指南》2022年第19期51-54,共4页Guide of China Medicine

摘　　要：目的比较COPD、哮喘-COPD重叠综合征、支气管哮喘患者血清TNF-α、IL-17和IL-18水平与肺功能参数的关系。方法选取2018年12月至2020年12月在我院治疗的COPD患者98例(COPD组),支气管哮喘患者95例(哮喘组),ACO患者92例(ACO组),对比3组一般资料、血清TNF-α、IL-17和IL-18水平及肺功能指标。结果各组患者性别、年龄、吸烟史、FEV1、FEV1/FVC、FEV1/pre%差异有统计学意义(P<0.05)。与对照组相比,COPD组、哮喘组和ACO组血清TNF-α、IL-17和IL-18均明显升高(P<0.05),但COPD组,哮喘组和ACO组间无明显差异(P>0.05),且COPD、ACOⅣ级IL-17最高(P<0.05),且COPDⅡ级IL-18水平最高,ACOⅣ级IL-18水平最高,且COPDⅣ级TNF-α水平最高,ACOⅢ级TNF-α水平最高。相关性结果显示,COPD和ACO患者中,IL-17、IL-18和TNF-α水平呈正相关(P<0.05)。COPD、ACO和哮喘患者IL-17均与FEV1、FEV1/FVC、FEV1/pre%呈明显负相关(P<0.05)。ACO患者IL-18与FEV1、FEV1/FVC、FEV1/pre%呈明显负相关(P<0.05)。COPD,ACO患者TNF-α水平与FEV1、FEV1/FVC、FEV1/pre%呈明显负相关(P<0.05)。结论IL-17在COPD患者气道阻塞的严重程度上具有最显著的影响;IL-18作为ACO患者支气管阻塞严重程度的潜在标记;而TNF-α在COPD及ACO患者气道阻塞严重程度上有显著影响。Objective To compare the relationship between serum TNF-α,IL-17 and IL-18 and lung function parameters in patients with COPD,asthma-COPD overlap syndrome and bronchial asthma.Methods From December 2018 to December 2020,98 COPD patients(COPD group),95 asthma patients(asthma group),92 ACO patients(ACO group)were selected from our hospital.The general data,serum TNF-α,IL-17 and IL-18 levels and lung function indexes were compared among 3 groups.Results There were statistically significant differences in gender,age,smoking history,FEV1,FEV1/FVC and FEV1/pre%among all groups(P<0.05).Compared with the control group,serum TNF-α,IL-17 and IL-18 in COPD group,asthma group and ACO group were significantly increased(P<0.05),but there were no significant differences between COPD group,asthma group and ACO group(P>0.05),and the highest IL-17 in COPD and ACO classⅣ(P<0.05).The level of IL-18 in COPDⅡwas the highest,the level of ACOⅣwas the highest(P<0.05),the level of TNF-αin COPDⅣwas the highest,the level of ACOⅢwas the highest(P<0.05).Correlation results showed that Il-17,IL-18 and TNF-αlevels were positively correlated in COPD and ACO patients(P<0.05).Il-17 was negatively correlated with FEV1,FEV1/FVC and FEV1/pre%in COPD,ACO and asthma patients(P<0.05).Il-18 was negatively correlated with FEV1,FEV1/FVC and FEV1/pre%in ACO patients(P<0.05).TNF-αlevels were negatively correlated with FEV1,FEV1/FVC and FEV1/pre%in COPD and ACO patients(P<0.05).Conclusion IL-17 has the most significant influence on the severity of airway obstruction in COPD patients.Il-18 is a potential marker of the severity of bronchial obstruction in ACO patients.

关 键 词：COPD 支气管哮喘 哮喘-COPD重叠综合征 TNF-Α IL-17 IL-18 

分 类 号：R563.9[医药卫生—呼吸系统] R562.25[医药卫生—内科学]