论文部分内容阅读
目的观察慢性阻塞性肺疾病(COPD)患者体内白介素-6(IL-6)和C反应蛋白(CRP)的质量浓度变化及其与气流受限、急性发作是否相关。方法同步收集中南大学湘雅二医院2004年2月至7月54例COPD稳定期患者和10名健康对照者的诱导痰和空腹静脉血,测定诱导痰上清液和血清中的IL-6和CRP质量浓度,进行比较。结果(1)COPD各组痰IL-6均较正常对照组显著增高(P<0.01),血清IL-6在COPDⅢ级、Ⅳ级较正常对照组显著增高(P<0.05),COPD患者痰IL-6显著高于自身血清IL-6(P<0.01);COPDⅡ级、Ⅲ级和Ⅳ级痰CRP较正常对照组显著增高(P<0.01),COPDⅢ级和Ⅳ级血清CRP较正常对照组显著增高(P<0.01),COPD患者血清CRP显著高于自身痰CRP质量浓度(P<0.01)。(2)痰IL-6与肺功能气流受限指标第1秒用力呼气容积占预计值百分比(FEV1%)、第1秒用力呼气容积占用力肺活量百分比(FEV1/FVC%)呈负相关。痰IL-6和CRP与急性发作次数呈正相关。结论IL-6和CRP参与了稳定期COPD患者气道慢性炎症;重度气流受限的稳定期COPD患者体内存在系统性炎症反应;痰IL-6含量有助于预测COPD患者急性发作频率。
Objective To investigate the changes of interleukin-6 (IL-6) and C-reactive protein (CRP) in patients with chronic obstructive pulmonary disease (COPD) and their relationship with air flow limitation and acute exacerbation. Methods Simultaneous collection of induced sputum and fasting venous blood from 54 patients with stable COPD and 10 healthy controls from Xiangya Second Hospital of Central South University from February 2004 to July 2004 was used to measure IL-6 and IL-6 in sputum supernatant and serum CRP concentration, for comparison. Results The levels of IL-6 in COPD group were significantly higher than those in normal control group (P <0.01), and the levels of IL-6 in COPD group were significantly higher than those in control group (P <0.05) (P <0.01). The CRP levels of COPD groupⅡ, Ⅲ and Ⅳ were significantly higher than those of normal control group (P <0.01). The serum levels of CRP in grade Ⅲ and Ⅳ of COPD were significantly higher than those of normal control group (P <0.01). The serum CRP in patients with COPD was significantly higher than that of their own sputum (P <0.01). (2) The sputum IL-6 was negatively correlated with FEV1 / FVC% of FEV1% and forced expiratory volume in one second if FEV1 / FVC% . The sputum IL-6 and CRP were positively correlated with the number of acute attacks. Conclusions IL-6 and CRP are involved in chronic airway inflammation in patients with stable COPD. Systemic inflammation is present in patients with stable COPD with severe airflow limitation. The sputum IL-6 content is helpful to predict the acute exacerbation frequency in patients with COPD.