慢性阻塞性肺疾病急性发作期外周血及痰中IL-8和TNF-α测定的意义

为探讨COPD患者急性发作期以及病情缓解后全身炎症和气道炎症的变化及二者的相关性。对 4 5例COPD急性发作期患者治疗前及 10～ 14d病情缓解后分别行血常规及肺功能检查测定FEV1 0 占预计值百分数 (FEV1 0 pre )、用ELISA法检测外周血浆和诱导痰液中IL 8和TNF α的水平 ,并记录诱导痰液中性粒细胞占白细胞百分比 (Neu/Leu % )。结果COPD急性发作时外周血浆及诱导痰液中Neu/Leu %、IL 8和TNF α均明显高于缓解后水平 (P均 <0 0 1) ,痰液Neu/Leu %、IL 8和TNF α与血浆Neu/Leu %、IL 8和TNF α水平无明显差异 (P均 >0 0 5 ) ,外周血及痰液TNF α与FEV1 0 pre无明显差异 (P均 >0 0 5 ),外周血IL 8与FEV1 0 pre有关 (r= 0 6 2 71,P <0 0 5 ) ,痰液Neu/Leu %、IL 8与FEV1 0 pre呈显著负相关 (r= 0 85 2 7,P <0 0 1)。痰液Neu/Leu %、IL 8与COPD气道阻塞密切相关 ,气道炎症与全身炎症无关

Significance of Detecting IL-8 and TNF-α in Peripheral Blood and Sputum During Acute Episodes in Patients with Chronic Obstructive Pulmonary Disease

To study the relationship between systemic inflammation and the airway inflammation during acute episodes and after disappearance of symptoms,serum samples and the induced sputum of 45 cases with acute exacerbations and in the stable period with treatment for 10～14 days were collected for testing,the pulmonary function being tested in all these cases,the levels of IL-8 and TNF-α in serum and sputum specimens being determined by immunoassay,and the ratio of neutrophils/leukocytes (Neu/Leu) in blood and sputum recorded.The results showed that:(1) The levels of IL-8,TNF-α and Neu/Leu in cases during exacerbation were significantly higher than those of cases in stable period. (2) There was no any correlation between the cytokine levels in serum and sputum. It concludes that there is no relation between systemic inflammation and the airway inflammation in patients with chronic obstructive pulmonary disease,but in sputum,IL-8 is obviously correlated with the airway obstruction in this kind of patients,so that,IL-8 in induced sputum may be a good indication of airway inflammation.