夜间低氧对慢性阻塞性肺疾病患者血清IL-6、IL-8的影响

目的:探讨慢性阻塞性肺疾病(COPD)患者夜间低氧与全身炎症反应的关系。方法:选择中度至极重度COPD患者70例,年龄45～74岁,平均(65.41±7.84)岁。按多导睡眠监测结果将研究对象分为低氧组和非低氧组,均行肺功能和多导睡眠监测、炎症指标检测。比较各组血清IL-6及IL-8的差异,分析炎症指标与睡眠呼吸参数的相关性。结果:睡眠低氧组27例,低氧率为38.57%,低氧组血清IL-6、IL-8分别为(14.34±2.76) ng/mL、(68.49±9.65) ng/mL,明显高于非低氧组的(11.79±1.85) ng/mL、(61.62±8.47) ng/mL(均P0.001)。经校正年龄、体质量指数后,IL-6与睡眠呼吸相关参数TS88正相关(r=0.651,P=0.041),与最低SaO_2和平均SaO_2负相关(r=-0.644,P=0.038和r=-0.780,P=0.018);IL-8与睡眠呼吸相关参数TS88正相关(r=0.627,P=0.039),与最低SaO_2和平均SaO_2负相关(r=-0.659,P=0.026和r=-0.732,P=0.014)。结论:中度至极重度COPD患者夜间低氧普遍存在,低氧组患者全身炎症反应明显增强,全身炎症反应与夜间低氧相关。

Effects of nocturnal hypoxia on serum IL-6 and IL-8 in patients with chronic obstructive pulmonary disease

Objective: To investigate the association between nocturnal hypoxia and systemic inflammatory response in patients with chronic obstructive pulmonary disease.Methods: Seventy moderate to very severe stable COPD patients with an age range of 45-74 years (Average age,65.41±7.84] years) were included.Patients were divided into nocturnal hypoxia group and non-nocturnal hypoxia group, and lung function, PSG, and inflammatory indicators were performed. The differences of serum IL-6 and IL-8 in each group were compared, the correlation between IL-6 and IL-8 as well as PSG parameters were further evaluated using partial correlation analysis.Results: Twenty-seven patients (38.57%) with nocturnal hypoxia were enrolled.Compared with patients without nocturnal hypoxia, serum IL-6 and IL-8 in the hypoxic group (14.34±2.76] ng/mL and68.49±9.65] ng/mL, respectively) were significantly higher than those in the non-nocturnal hypoxic group (11.79±1.85] ng/mL and61.62±8.47] ng/mL, respectively; P<0.001). Additionally, after adjustment for BMI and age, serum IL-6 level showed significant positive correlation with TS88 (r=0.651, P=0.041), nevertheless, serum IL-6 level showed significant negative correlation with the lowest SaO₂ and the mean SaO₂ (r=-0.644, P=0.038 and r=-0.780, P=0.018); serum IL-8 level showed significant positive correlations with TS88 (r=0.627, P=0.039), nevertheless, serum IL-6 level showed significant negative correlation with the lowest SaO₂ and the mean SaO₂ (r=-0.659,P=0.026 and r=-0.732, P=0.014).Conclusions: Nocturnal hypoxia generally exists in patients with moderate to very severe stable COPD. Compared with the non-nocturnal hypoxia group, the nocturnal hypoxia group has enhanced systemic inflammatory response, which might be correlated with nocturnal hypoxia.