吸烟对COPD患者肺功能及IL-8和TNF-α的影响

目的通过测定慢性阻塞性肺疾病(COPD)吸烟与非吸烟患者及健康人群的肺功能以及肿瘤坏死因子(TNF-α)、白细胞介素8(IL-8)水平,探讨吸烟对COPD患者肺功能、TNF-α、IL-8水平的影响。方法选择2012年3⁵月来天津市宝坻区人民医院呼吸科门诊就诊的50例处于稳定期的COPD患者作为研究对象,根据是否吸烟分为COPD吸烟组和COPD非吸烟组,选取同期来医院进行健康体检的26健康人作为健康对照组。采用酶联免疫吸附法测定所有受试者血清TNF-α、IL-8的水平,同时检测受试者的肺功能。结果 COPD吸烟组及COPD非吸烟组IL-8、TNF-α水平均显著高于健康对照组(P<0.05),而第一秒用力呼气量占用力肺活量百分率(FEV1%)则显著低于健康对照组(P<0.05);COPD吸烟组血清IL-8、TNF-α水平较COPD非吸烟组显著增高(P<0.05),FEV1%显著降低(P<0.05);COPD吸烟组受试者血清中IL-8、TNF-α水平与吸烟指数呈正相关(r=0.549,0.458,P<0.001),而FEV1%与吸烟指数呈明显负相关(r=-0.516,P<0.001)。结论吸烟可引起COPD患者血清IL-8、TNF-α水平升高,FEV1%降低。因此戒烟是预防和降低COPD发病率的重要措施,降低炎性因子的水平是改善COPD呼吸道炎症进展的新策略。

Study on Effects of Smoking on Lung Function,Interleukin-8 and Tumor Necrosis Factor a of Patients with Chronic Obstructive Pulmonary Disease

Objective To explore the effect of smoking on the lung function, the serum levels of tumor necrosis factor α （ TNF-α） , ineerleukin-8 （ IL-8 ） of patients with chronic obstructive pulmonary disease （COPD） by detecting the lung function, serum levels of TNF-α, IL-8 in COPD patients with and without habit of smoking and healthy people. Methods A total of 50 eases of COPD patients in stable phase admitted in Tianjin Baodi District People＇s Hospital from Mar. to May 2012 were divided into COPD smoking group and COPD non-smoking group, and another 26 healthy people underwent physical examination during the same period were selected as the control group. The serum levels of TNF-α, IL-8 of all the cases were meas- ured by enzyme-linked immunosorbent assay （ELISA） , at the same time their lung function was also tested. Results The serum levels of TNF-α,IL-8 in COPD smoking group and COPD non-smoking group were sig- nificantly higher than the control group （ P 〈 0.05 ）, while FEV1% of the two COPD groups were significantly lower than the control group （ P 〈 0.05 ） ; the TNF-α and IL-8 levels of COPD smoking group were significantly higher than COPD non-smoking group （P 〈 0.05 ）, and FEV1% of COPD smoking group was significantly lower than COPD non-smoking group（ P 〈 0.05 ）. The levels of TNF-α and IL-8 in COPD smoking group were positively correlated with smoking index（ r = 0. 549,0. 458, P 〈 0. 001） , and the level of FEV1% was negatively correlated with smoking index（ r = - 0.516 ,P 〈 0. 001）. Conclusion Smoking can lead to the rise of the serum levels of TNF-α and IL-8 of COPD patients, therefore, giving up smoking is the important measure for preventing and reducing the incidence of COPD. Reducing the level of inflammation factors is a new strategy to improve the progression of COPD airway inflammation.