慢性阻塞性肺疾病患者血清IL-8、hsCRP水平及临床意义的探讨

Serum IL-8,hsCRP Levels in Patients with Chronic Obstructive Pulmonary Disease and Their Clinical Significance

目的了解慢性阻塞性肺疾病(COPD)稳定期患者血清白细胞介素-8(IL-8)、高敏C反应蛋白(hsCRP)水平,探讨其影响因素及其临床意义。方法用酶联免疫吸附测定法(ELISA)同步检测54例中、重度COPD稳定期患者和20例健康对照者血清IL-8、hsCRP水平,分析其相关因素。结果COPD患者血清IL-8、hsCRP水平显著高于健康对照组(P均<0.01);其中COPD吸烟组血清IL-8、hsCRP水平显著高于COPD非吸烟组血清IL-8(P<0.01)、hsCRP(P<0.05)水平;重度COPD患者血清IL-8、hsCRP水平明显高于中度COPD患者(P均<0.01)。相关分析表明,血清IL-8、hsCRP与吸烟年包、SGRQ生活质量症状、社会影响及总评分呈显著正相关(P均<0.01),与FEV1呈负相关(P<0.05)。此外,COPD患者血清hsCRP还与生活质量活动能力评分正相关(P<0.01),与6分钟步行试验(6MWT)呈显著负相关(P<0.05),而且血清IL-8和hsCRP二者之间呈显著正相关(P<0.001)。结论中重度COPD稳定期患者血清IL-8、hsCRP水平均升高,吸烟可能是血清IL-8、hsCRP水平升高的一个影响因素。此外,气流受限越重,生活质量越差,血清IL-8、hsCRP水平越高,提示COPD稳定期患者不仅存在气道炎症也存在全身炎症反应,气流受限程度可以影响周身炎性反应及生活质量。

Objective To understand the serum interleukin-8 (IL-8),high sensitive C-reactive proteins (hsCRP)levels,their correlation factors and clinical significance in patients with stable chronic obstructive pulmonary disease (COPD). Methods The serum IL-8,hsCRP levels in 54 stable COPD patients and 20 healthy controls were measured by enzyme-linked immunosorbent assay(ELISA).Correlation factors of serum IL-8,hsCRP levels were analyzed. Results The serum IL-8,hsCRP levels in COPD patients were significantly higher than those in the healthy controls(P < 0.01). The serum IL-8,hsCRP levels in smoking COPD patients were significantly higher than that in the non- smoking controls(P < 0.01 and P < 0.05 respectively). The serum IL-8,hsCRP levels in severe COPD patients were significantly higher than those in the moderate patients(P < 0.01);Linear correlation analysis showed that the levels of serum IL-8,hsCRP were significantly positive associated with smoking pack-years,symptom scores,impact scores and total scores of quality of life with St. George,S Questionnaire(SGRQ) (P < 0.01).There was a negative correlation between the serum IL-8,hsCRP levels and forced expiratory volume in one second(FEV1)(P < 0.05). Moreover,the serum hsCRP level was positive associated with activity scores of quality of life(P < 0.01)and negative associated with six-minutes walking distance(6MWD)(P < 0.05). There was a positive correlation between the serum IL-8 level and serum hsCRP leve(lP < 0.001). Conclusion The serum IL-8,hsCRP levels in stable COPD patients were higher. Smoking maybe is an factor which affects serum IL-8,hsCRP levels. The more severe is airflow limitation and the worst is quality of life,the higher the serum IL-8,hsCRP levels are. It showed that not only is airway inflammation but also systemic inflammation could coexist in stable COPD patients. Airflow limitation can af- fect systemic inflammation and quality of life.