慢性阻塞性肺疾病不同时期气道炎症反应和细胞因子水平的变化及其意义

目的探讨慢性阻塞性肺疾病（chronic obstructive pul monary disease,COPD）患者急性发作期与稳定期气道炎症反应和细胞因子的水平变化及其意义。方法 25例COPD急性发作期患者（COPD急性发作期组）、25例COPD稳定期患者（COPD稳定期组）及25例健康体检者（正常对照组）应用肺功能测定仪测定第1秒用力呼气量（FEV1.0）,ELISA法和瑞氏-姬姆萨染色分别检测痰中白细胞介素8（interleukin-8,IL-8）和C反应蛋白（C-reactiveprotein,CRP）水平,以及计数白细胞总数、计算炎症细胞（中性粒细胞及嗜酸性粒细胞）的百分率。结果 COPD急性发作期组FEV1.0%pred为（39.72±8.3）%,显著低于COPD稳定期组的（59.36±3.37）%和正常对照组的（86.21±6.52）%（均P〈0.01）;COPD急性发作期组痰上清液中IL-8和CRP水平分别为（25.39±6.77）ng.L-1、（8.39±3.82）g.L-1,均显著高于COPD稳定期组（6.14±2.26）ng.L-1、（4.67±2.13）g.L-1]和正常对照组（2.44±0.63）ng.L-1、（0.09±0.21）g.L-1]（均P〈0.01）。COPD急性发作期组痰液中白细胞总数和中性粒细胞比例分别为（8.7±6.9）×109L-1、（64.3±9.2）%）,均显著高于COPD稳定期组（5.2±4.8）×109L-1、（52.9±9.9）%]和正常对照组（2.3±1.4）×109L-1、（28.6±7.9）%]（均P〈0.01）。结论 COPD急性发作期患者气流受限、中性粒细胞以及炎症因子（CRP）和炎症细胞因子（IL-8）等随炎症反应程度的增加而加重,COPD应以控制感染性炎症为首要。

Change and Significance of Inflammatory Reaction and Cytokines in Induced Sputum from Patients with Chronic Obstructive Pulmonary Disease in Different Stages

Objective To explore the state and significance of airway inflammation for the patients with COPD （chronic obstructive pulmonary disease） in different stages. Methods Examining the forced expiratory volume in 1 second （FEV1.0） by pulmonary function equipment and Measuring interleukin-8 （IL-8） and C-reactiveprotein （CRP） in induced sputum by ELISA for 25 acute exacerbation patients with COPD,25 stable patients with COPD and 25 healthy control subjects. Total white cell numbers and the percent of neutrophils and eosnophils were counted by Wright-Giemsa Stain and under microscope. Re- sults The FEV1.0 % pred was lower in acute exacerbation patients with COPD （39.72 ± 8. 3） % than in stable patients with COPD（59. 36±3. 37） %（P〈0. 01） and healthy control subjects（86. 21 ±6. 52）% （P〈0.01）. In induced sputum the level of IL-8 and CRP was higher in acute exacerbation pa- tients with COPD （25.39±6.77）ng · L-1 and （8.39±3.82）g · L-1 than in stable patients with COPD（6.14±2.26）ng · L-1,（4. 67±2. 13）g · L-1]（P〈0.01） and healthy control sub- jects（2.44±0.63）ng· L-1,（0.09±0.21）g· L-1] （P〈0. 01）. In induced sputum the total white cell numbers and the percent of neutrophils was higher in acute exacerbation patients with COPD（8.7±6.9）×109L-1、（64.3±9.2）%） ] than in stable patients with COPDF（（5.2±4.8）×109L-1、（52.9±9.9）%） and healthy eontrol subjects （2.3±1.4）×109L-1、（28.6±7.9）%] （P〈0.01）. Conclusions The neutrophilie infiltrate,IL-8 and CRP rise within air passage are included in COPD,and it is aggravated along with inflammation exacerbation. So it is key to control infectious inflammation for preventing and relieving COPD.