炎性因子在慢性阻塞性肺疾病急性加重期的作用研究

目的探讨慢性阻塞性肺疾病急性加重（AECOPD）患者治疗前后血IL-10、IL-23、CRP等炎症因子的浓度变化及其与肺功能损害的相关性。方法采用EHSA分析50例AECOPD患者治疗前后血清IL-10、IL-23、C-反应蛋白，测PaO2、FEV1、FEV1／FVC％、外周血白细胞计数和中性粒细胞百分比，分析IL-10、IL-23、CRP与FEV1和FEV1／FVC％的相关性。结果在AE—COPD患者中，治疗前后IL-10浓度分别为（179．9±73．8pg／L）和（223．5±107．8pg／L），比对照组（364．3±160．2pg／L）低；治疗前后IL-23浓度分别为（189．4±103．7pg／L）和（177．2±103．2pg／L），均比对照组（89．7±64．4pg／L）高；治疗前后CRP浓度分别为（24．1±18．2mg／L）和（10．2±4．6mg／L），均比对照组（5．6±1．9mg／L）高；差异均有统计学意义。IL-10浓度与FEV1％、FEV1／FVC变化呈正相关（r=0．782，r=0．575，P〈0．05）；IL-23浓度与FEV1％、FEV1／FVC呈负相关（r=-0．586，r=-0．453，P〈0．05）；CRP浓度与FEV1％、FEV1／FVC呈负相关（r=-0．725，r=-0．643，P〈0．05）。结论AECOPD患者血IL-10浓度较对照缉低．而IL-23和CRP浓度较对照组高；血IL-10、IL-23和CRP的浓度与肺功能损害程度相关。

The role of inflammatory factor in the exacerbation of chronic obstructive pulmonary diseases

Objective To investigate the changes of Interleukin-10 （IL-10）, Interleukin-23 （IL-23） and C-reactive protein （CRP） levels in patients with acute exacerbation of chronic obstructive pulmonary diseases （AECOPD） and to analyze the correlation between the inflammatory factor and COPD. Methods The levels of IL-10, IL-23 and CRP in fifty cases of patients with AECOPD were measured by enzyme-linked immunosorbent assay. The amounts of neutrophils, PaO2 and lung function indexes such as the forced expiratory volume in one second （FEV1 ） and the forced expiratory volume in one second/forced vital capacity （FEV1/FVC） were also determined. Results From the time of beginning therapy to the time of after-therapy,the AECOPD patients showed a significant decrease in IL-10 （179.9 ±73.8 pg/L,223.5 ± 107.8 pg/L respectively）vs （364. 3 ± 160. 2 pg,/L） ] ,but showed a notable increase in IL-23 （ 189. 4 ± 103.7 pg/L, 177.2 ± 103.2 pg/L）vs（89.7 ± 64. 4 pg/L） ] and CRP （24. 1 ± 18.2 mg/L, 10. 2 ± 4. 6 mg/L respectively） vs（5.6 ± 1.9 mg/L） ]. After administration ,the patients showed a significant decrease in peripheral leucocyte counts （5.43 ± 1.1 ） vs （7.2 ±3.9 and） ] in the ratio of neutrophils （65 ±4. 9）vs （74. 5 ± 11.9） ] ,but showed a notable increase in arterial partial pressure of oxygen （66. 1 ± 8. 0 mmHg） vs （56. 5 ± 11.9 mmHg）]. In Spearman correlation analysis, serum IL-10 concentrations with FEV1% （r = 0. 782,P 〈0. 05） and FEV1/FVC （r =0. 575 ,P 〈0. 05） were positively correlated,while IL-23 and CRP with FEV1% （ r = - 0. 586,r = - 0. 725 respectively,P 〈 0. 05 ） and FEV1 / FVC （ r = - 0. 453, r = - 0. 643 respectively,P 〈 0. 05 ） were negatively correlated. Conclusion The serum IL-10 levels in the patients with AECOPD is lower than that of the healthy control group,while IL-10 and CRP levels are higher than that of the healthy control group. The damage of lung function in patients with AECOPD is associa