病毒相关性慢性阻塞性肺疾病急性加重与血清干扰素γ和白介素8的相关性研究

目的了解血清干扰素γ(IFN-γ)和白介素8(IL-8)与病毒相关性慢性阻塞性肺疾病急性加重(AECOPD)的关系。方法纳入AECOPD患者66例,根据咽拭子标本的病毒抗原免疫荧光检测结果,将患者分为病毒感染组(n=21)和非病毒感染组(n=45),另取20例健康体检者作为对照组。收集66例患者入院24h内的临床资料(临床症状、吸烟史、是否接受机械通气治疗、机械通气时间、ICU住院时间、痰培养结果),并采用ELISA法对三组血清IFN-γ和IL-8水平进行检测。结果病毒感染组ICU住院时间较非病毒感染组长(P<0.05),但其细菌、真菌检出率,接受机械通气的患者例数及机械通气时间,吸烟史以及临床症状与非病毒感染组比较均无统计学差异。血清IFN-γ水平在病毒感染组、非病毒感染组和对照组间无统计学差异,而血清IL-8水平在病毒感染组最高(P<0.05),非病毒感染组次之,对照组最低。结论血清IL-8水平与病毒相关性AECOPD相关,可作为炎症反应进一步失调的证据之一,反映AECOPD病情严重度。

Correlation between interleukin-8,interferon-gamma and virus-associated acute exacerbation of chronic obstructive pulmonary disease

Objective To explore the association between interleukin-8(IL-8),interferon-gamma(IFN-γ)and the pathogenesis of virus-associated acute exacerbation of chronic obstructive pulmonary disease(AECOPD)on the basis of retrospective case-control study of patients with COPD.Methods Sixty-six patients with AECOPD were enrolled and grouped into 2 groups according to the results of immunofluoresence screen assay for virus in throat swabs:virus-infected group(21 cases)and non-virus-infected group(45 cases).Twenty healthy volunteers screened from medical check-up were enrolled as control group.The clinical data within 24h after admission,symptoms,history of smoking,whether or not underwent mechanical ventilation,duration of mechanical ventilation,length of ICU stay,culture results of sputum specimen,were collected.Serum concentrations of IFN-γ and IL-8 were detected by ELISA assay.Results The length of ICU stay was longer in virus-infected group than in non-virus-infected group(P＜0.05),while no significant differences were found between the 2 groups in the detection rate for bacteria and fungus,the number of cases undergoing mechanical ventilation,the duration of mechanical ventilation,the history of smoking and the clinical symptoms.The highest IL-8 level was found in virus-infected group,the next was in nonvirus-infected group,and the lowest level was found in control group(P＜0.05),while no significant difference was found in IFN-y levels among the three groups.Conclusion A certain correku'on exists between IL-8 level in serum and virus-associated AECOPD.Such correlation may be considered as one of the evidences of aggravated inflammatory reaction,reflecting the degree of severity of AECOPD.