吸烟与慢性阻塞性肺病系统性炎症反应的关系

目的评价吸烟对慢性阻塞性肺病(COPD)全身系统性炎症反应的影响。方法该横断面研究共纳入144名研究对象,分为四组:不吸烟对照组(n=36),吸烟对照组(n=30),不吸烟伴COPD组(n=41),吸烟伴COPD组(n=37)。用酶联免疫吸附法(ELISA)测量每组研究对象的血清C-反应蛋白(CRP)、肿瘤坏死因子-α(TNF-α)以及白细胞介素-6(IL-6)等炎症因子水平。结果吸烟引起研究对象血清CRP、TNF-α、IL-6等炎症因子水平升高(均P0.05),多元Logistic回归提示TNF-α水平与研究对象吸烟状态及罹患COPD都独立相关(均P0.05),CRP、IL-6水平仅与研究对象罹患COPD独立相关(均P0.05)。结论吸烟会引起全身系统性炎症反应增高,这种增高可能是由TNF-α介导的,并且可能在COPD的发病中起着重要的作用,该研究结果提示戒烟可能会降低TNF-α介导的全身系统性炎症反应,从而能使COPD患者受益。

Relationship Between Smoking and Systemic Inflammation in Patients with Chronic Obstructive Pulmonary Disease

Objective To assess the association between systemic inflammation and smoking status in patients with chronic obstructive pulmonary disease（COPD）. Methods Totally 144 patients were included in this cross-sectional study.The patients were divided into non-smoker controls（n=36）,smoker controls（n=30）,non-smokers with COPD（n=41）,and smokers with COPD（n=37）.We measured serum CRP,TNF-α and IL-6 levels in all the patients using enzyme-linked immunosorbent assay（ELISA） kit. Results Smoking increased serum CRP,TNF-α and IL-6 levels in all the patients（all P〈0.05）.Multiple logistic regression analysis showed that TNF-α levels were associated with smoking status and COPD attack（both P〈0.05）.CRP,IL-6 levels were correlated with COPD attack（both P〈0.05） but not with smoking status. Conclusion Smoking may aggravate TNF-α mediated systemic inflammation,which may play a key pathophysiological role in COPD.Smoking cessation may be clinically useful for patients with COPD by inhibiting TNF-α mediated systemic inflammation.