AECOPD患者C5a、IL-6、IL-17与病情严重程度的关系及延续干预对患者生活质量的影响  

Relationship between C5a,IL-6,IL-17,and the severity of AECOPD patients and the continued intervention model for their quality of life

作　　者：邓梅毓 郭晓峰 赵建清[1] 李静[1] 李峰 DENG Meiyu;GUO Xiaofeng;ZHAO Jianqing;LI Jing;LI Feng(Department of Respiratory and Critical Care Medicine,the First Affiliated Hospital of Hebei North University,Zhangjiakou 075000,Hebei,China)

机构地区：[1]河北北方学院附属第一医院呼吸与危重症医学科,河北张家口075000

出　　处：《贵州医科大学学报》2023年第12期1545-1550,共6页Journal of Guizhou Medical University

基　　金：中国宋庆龄基金会项目(2018MZFZY-003);河北省卫生健康委科研基金(20180868)。

摘　　要：目的分析慢性阻塞性肺疾病急性加重期(AECOPD)患者血清补体5a(C5a)、白细胞介素-6(IL-6)、IL-17与病情程度的关系及延续干预对患者生活质量的影响。方法选取80例AECOPD患者作为观察组,根据干预模式分为常规组和延续模式组,常规组给予常规宣教,延续模式组在常规宣教基础上给予延续干预,另选取同期本院体检中心健康体检者80例设为对照组;采用酶联免疫吸附法(ELISA)检测观察组干预前、干预3月时,对照组体检当天的血清C5a、IL-6、IL-17水平;采用肺功能检测仪检测患者第1秒用力呼气容积(FEV1),圣乔治呼吸生活质量量表(SGRQ)评估常规组和延续模式组予以干预前后的生活质量;根据FEV1将观察组再分为轻度组(n=20)、中度组(n=39)、重度组(n=15)及极重度(n=6),比较4组干预前血清C5a、IL-6、IL-17水平;采用受试者工作曲线(ROC)分析观察组干预前的血清C5a、IL-6、IL-17对AECOPD的诊断价值;并采用Pearson分析观察组干预前血清C5a、IL-6、IL-17与FEV1的相关性。结果观察组干预前血清C5a、IL-6、IL-17水平均高于对照组(P<0.05);不同病情程度组干预前血清C5a、IL-6、IL-17水平比较,观察组中极重度组>重度组>中度组>轻度组,差异有统计学意义(P<0.05);观察组干预前血清C5a、IL-6、IL-17联合检测诊断AECOPD的灵敏度、特异度均高于单一检测;观察组干预前血清C5a、IL-6、IL-17与FEV 1均呈负相关性(r=-0.412、-0.384、-0.397,P<0.01);延续模式组干预后血清C5a、IL-6、IL-17水平均低于常规组,FEV 1高于常规组,SGRQ各维度评分及总分均低于常规组,差异有统计学意义(P<0.05)。结论AECOPD患者血清C5a、IL-6、IL-17呈异常高表达,与病情严重程度有相关性,延续干预可有效改善患者生存质量及预后。Objective To investigate the relationship between serum complement 5a(C5a),interleukin-6(IL-6),IL-17,and the severity of the disease in patients with acute exacerbation of chronic obstructive pulmonary disease(AECOPD),and the impact of continuous intervention mode on the quality of life of patients.Methods A total of 80 AECOPD patients were selected as the observation group(further divided into regular group and continuation group).Regular group received routine popular science education,and continuation group received continuous intervention on the basis of routine popular science education.Additionally,80 healthy examinees from the same period's physical examination center were selected as the control group.Enzyme-linked immunosorbent assay(ELISA)was used to detect the levels of serum C5a,IL-6,and IL-17 of observation group before intervention,3 months after intervention and the day of physical test of the control group.The first second forced expiratory volume(FEV1)was detected by pulmonary function detector,and the life quality scores of the routine regular group and the continuation group were compared by St.George's Respiratory Quality of Life scale(SGRQ)before and after intervention.According to FEV1,the observation group was further divided into mild group(n=20),moderate group(n=39),severe group(n=15)and extremely severe group(n=6).The levels of serum C5a,IL-6,and IL-17 in the 4 groups before intervention were compared.Before intervention,the diagnostic value of serum C5a,IL-6,and IL-17 in AECOPD in the observation group was analyzed by receiver operating curve(ROC).The correlation between serum C5a,IL-6,IL-17 and FEV1 in the observation group before intervention was analyzed by Pearson analysis.Results he levels of serum C5a,IL-6,and IL-17 in observation group were higher than those in control group(P<0.05).The levels of serum C5a,IL-6 and IL-17 in different severity groups before intervention were compared,the observation group showed:extremely severe group>severe group>moderate group>mild group,differe

关 键 词：补体5a 白细胞介素-6 白细胞介素-17 慢性阻塞性肺疾病 延续干预模式 生活质量 

分 类 号：R563.5[医药卫生—呼吸系统]