白细胞介素6在慢性阻塞性疾病患者痰和血清中的浓度变化

目的探讨慢性阻塞性肺疾病(chronic obstructive pulmonary disease,COPD)患者痰和血清中白介素-6(interleukin-6,IL-6)的浓度变化及其与气流受限之间的关系.方法采集54例COPD患者和10例正常健康对照者的痰标本及同期血标本,并做肺功能检查,用双抗体夹心ELISA法测定痰和血清中IL-6浓度,分析它们与气流阻塞相关指标第一秒用力呼气容积与预计值百分比(FEV1%pre)、第一秒用力呼气容积占用力肺活量百分比(FEV1/FVC%)、肺残气量(RV)的相关性.结果COPD各极患者痰中IL-6浓度均高于正常对照组(P＜0.05或P＜0.01);COPD患者血清IL-6浓度仅在Ⅱb级、Ⅲ级时高于正常对照组(P＜0.05).COPD患者痰中IL-6浓度明显高于自身血清中IL-6浓度(P＜0.01),且与FEV1%pre负相关(r=-0.752,P＜0.01),与FEV1/FVC%负相关(r=-0.693,P＜0.01),与RV正相关(r=-0.558,P＜0.01);而血清IL-6浓度与FEV1%pre、FEV1/FVC%亦存在负相关(r=-0.561,P＜0.01;r=-0.473,P＜0.01),与RV正相关(r=0.342,P＜0.01).结论COPD患者呼吸道局部IL-6浓度高于外周血IL-6浓度;痰IL-6可更好地反映COPD患者支气管肺泡局部的病理生理变化及气流阻塞的程度;IL-6可能参与了COPD的慢性气道炎症过程及气道重塑过程.

Relation of sputum and serum IL-6 levels to airflow obstruction in patients with chronic obstructive pulmonary disease (COPD)

Objective] To investigate sputum and serum IL-6 levels and their relationships to airflow obstruction in the patients with chronic obstructive pulmonary disease (COPD). Methods] 54 patients with COPD and 10healthy controls were enrolled in the study and adopted pulmonary function test. Sputum and serum IL-6 levels were measured by enzyme-lined immune sorbeat assay (ELISA). Relationship between sputum IL-6, serum IL-6 levels and airflow obstruction indexes (FEV1% pre, FEV1/FVC%, RV) were analyzed. Results] Sputum IL-6 levels in all stages of COPD patients were higher than those in healthy controls (P ＜0.05), but only stage Ⅱ b and stage ⅢCOPD patients' serum IL-6 levels were higher than healthy controls' serum IL-6 levels (P ＜0.05). Sputum IL-6 levels were higher than serum IL-6 levels in all COPD patients (P ＜0.01). Correlation coefficients between sputum IL-6and FEV1%pre, FEV1/FVC%, RV are r =-0.752 (P ＜0.01), r =0.693 (P ＜0.01) and r =0.558 (P ＜0.01) respectively.Correlation coefficients between serum IL-6 and FEV1%pre, FEV1/FVC%, RV are r ＝0.561 (P ＜0.01), r =0.473 (P＜0.01) and r ＝0.342 (P ＜0.01) respectively. Conclution] IL-6 in airway was greater than in peripheral blood in COPD patients. Sputum IL-6 level is better to reflect the degree of airflow obstruction and the pathological change of bronchi-lung. IL-6 may be involved in the chronic airway inflammatory and airway remodelling process.