慢性阻塞性肺疾病患者诱导痰中白介素8、白三烯B4、髓过氧化物酶的变化以及噻托溴铵对其的影响

目的 探讨慢性阻塞性肺疾病(COPD)患者中自三烯B4(LTB4)、白介素8(IL-8)、髓过氧化物酶(MPO)的变化及噻托溴铵对其的影响,进一步验证噻托溴铵是否有抗炎作用.方法 选中度至极重度COPD稳定期患者30例为噻托溴铵治疗前组,予吸入噻托溴铵30 d,剂量18μg·d-1,为噻托溴铵治疗后组.并选10例健康查体者为对照组,本组无任何干预措施.三组均进行血气分析、肺功能检查和诱导痰沉渣细胞计数和痰上清液ELISA法测定IL-8、LTB4、MPO.采用独立样本t检验及配对t检验,Pearson及Spearman相关等分析.结果 噻托溴铵组与健康对照组痰细胞分类、IL-8(777.05±392.43)pg·ml-1vs(311.27±135.93)pg·ml-1]、LTB4(96.70±29.13)pg·ml-1vs(20.60±9.89)pg·ml-1]、MPO(23.50±16.77)U·ml-1 vs(10.52±3.55)U·ml-1]指标比较,差异均具有统计学意义.噻托澳铵治疗前后痰细胞分类比较,差异无统计学意义,IL-8(777.05±392.43)pg·ml-1vs(408.93±339.14)pg·ml-1]、LTB4(96.70±29.13)pg·ml-1 vs(43.69±16.49)pg·ml-1]差异有统计学意义.相关分析示IL-8与PaO2(r=-0.411)、肺功能指标FEV1%pred(r=-0.440)、FVC%pred(r=-0.440)、FEV1/FVC%(r=-0.417)有相关性.结论 COPD患者诱导痰中炎性细胞及炎性因子与健康对照组比较,差异有统计学意义.噻托溴铵对COPD患者诱导痰中IL-8、LTB4有降低作用.

Changes of interleukin-8, leukotriene B4 and myeloperoxidase in induced sputum of patients with chronic obstructive pulmonary disease and the effects of tiotropium

Objective To investigate the changes of interleukin-8(IL-8),leukotriene B4(LTB4) and myeloperoxidase(MPO) in induced sputum of patients with chronic obstructive pulmonary disease(COPD)and the effects of tiotropium. To identify the anti-inflammatory function of tiotropium. Methods We admitted 30 moderate to very severe stable COPD patients as tiotropium pre-therapy. At the same time,the same patients as tiotropium post-therapy when they were received inhaled tiotropium 18μg · d-1 for one month. Ten age-matched healthy objects were included as controls. The following measurements were performed for each group:arterial blood gases,pulmonary function,cell diferentials in induced sputum,and concentrations of IL-8,LTB4 and MPO in induced sputum by using enzyme linked immunosorbent assay (ELISA). Analysis with Independent-Samples T Test, Paired-Samples T Test and Pearson correlate coefficients and so on. Results The concentrations of IL-8,LTB4,MPO in induced sputum in tiotropium pre-therapy group were significantly higher than those in group controls IL-8 (777.05±392.43) pg · ml-1 vs (311. 27±135.93) pg· ml-1],LTB4 (96. 70±29.13) pg· ml-1 vs (20.60±9.89) pg· ml-1],MPO (23.50±16.77) U · ml-1 vs (10.52±3.55) U · ml-1 ],respectively. And the concentrations of IL-8,LTB4 in tiotropium pre-therapy group were also significantly higher than those in tiotropium post-therapy group IL-8(777.05± 392.43) pg · ml-1 vs (408.93 ± 339.14) pg · ml-1 ], LTB4 (96.70 ± 29.13)pg · ml-1 vs (43.69± 16.49) pg · ml-1 ]. There were no significant changes either in cell counts or in the level of MPO in induced sputum. IL-8 was correlated with PaO2 ( r = - 0. 411 ), FEV1 % ( r = - 0.440),FVC%( r =-0.440),FEV1/FVC%( r = -0.417),respectively. Conclusions Cell diferentials,IL-8,LTB4 and MPO in induced sputum are different between COPD patients and healthy controls. Inhaledtiotropium therapy reduces the levels of IL-8,LTB4 in induced sputum in COPD patients.