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目的 探讨 3种细胞因子和炎症细胞在慢性阻塞性肺疾病 (COPD)发病机制中的作用。方法 收集 2 0例稳定期COPD患者、10名健康吸烟者 (HS)和 10名健康不吸烟者 (HNS)的痰液。对痰液进行炎症细胞计数与分类检查 ,并用放射免疫法测定痰液中白细胞介素 8(IL 8)、白细胞介素 6(IL 6 )与肿瘤坏死因子α(TNF α)水平。结果 COPD组痰液IL 8、TNF α水平及中性粒细胞分类 (PMN)明显高于HS组和HNS组 (P <0 0 1)。HS组痰液IL 8水平及PMN明显高于HNS组 (P <0 0 5 )。痰液IL 6水平在 3组之间差异无显著性 (P >0 0 5 )。COPD组痰液IL 8水平与TNF α水平及PNM呈显著正相关 (r′s=0 5 999、0 6 737) ,HS组痰液IL 8水平与PMN也呈显著正相关 (rs=0 842 4)。在COPD组 ,痰液IL 8、TNF α水平及PMN与一秒钟用力呼气容积占预计值百分比 (FEV1占预计值 % )、一秒钟用力呼气容积 /用力肺活量 (FEV1/FVC)呈显著负相关 (r′s=- 0 6 45 3、- 0 734 1、- 0 734 1、- 0 76 2 4、- 0 5 2 6 2、- 0 735 3)。结论 IL 8、TNF α和中性粒细胞共同参与了COPD气道炎症反应并导致气流阻塞的形成。
Objective To investigate the role of three cytokines and inflammatory cells in the pathogenesis of chronic obstructive pulmonary disease (COPD). Methods Twenty patients with stable COPD, 10 healthy smokers (HS) and 10 healthy non-smokers (HNS) were collected. Inflammatory cells were counted and sorted for sputum, and the levels of interleukin 8 (IL 8), interleukin 6 (IL 6) and tumor necrosis factor α (TNF α) in sputum were measured by radioimmunoassay. Results The levels of IL 8, TNFα and PMN in sputum of COPD group were significantly higher than those in HS group and HNS group (P <0.01). The sputum IL 8 level and PMN in HS group were significantly higher than those in HNS group (P <0.05). There was no significant difference in sputum IL 6 level between the three groups (P> 0.05). IL 8 levels in sputum from COPD patients were positively correlated with TNFα levels and PNM (r’s = 0 5 999,0 6 737), while sputum IL 8 levels in HS patients were also positively correlated with PMN (rs = 0 842 4). In the COPD group, sputum IL 8 and TNFα levels and PMN and forced expiratory volume per second accounted for the expected percentage (FEV1% predicted), forced expiratory volume / forced vital capacity (FEV1 / FVC) (R’s = - 0 6 45 3, - 0 734 1, - 0 734 1, - 0 76 2 4, - 0 5 2 6 2, - 0 735 3). Conclusion IL-8, TNF-α and neutrophils participate in airway inflammatory reaction of COPD and lead to the formation of airflow obstruction.