老年慢性阻塞性肺疾病白介素和肿瘤坏死因子-α测定的临床意义

Clinical significance of the serum levels of IL-6,IL-8 and TNF-α in elderly patients during acute episodes of chronic obstructive pulmonary disease

目的探讨老年慢性阻塞性肺疾病（COPD）患者血清白介素（IL-6、IL-8）、肿瘤坏死因子-α（TNF—α）测定的临床意义。方法21例老年COPD急性加重期住院患者，分别于治疗前及治疗10～14d病情缓解后查血常规、肺功能并计算第1秒用力呼气量（FEV1）占预计值百分比（FEV1Pre），用EHSA法检测血清IL-6、IL-8、TNF—α浓度。结果COPD急性加重期时外周血中性粒细胞占白细胞总数百分比（Neu／Leu％）、血清IL-6、IL-8、TNF—α浓度均明显高于缓解后水平（均P〈0．01），而急性加重期FEV1Pre明显低于缓解后水平（P〈0．01）。IL-8、IL-6、TNF—α与FEV1Pre均呈负相关（P〈0、05），Neu／Leu％与FEV1Pre无明显相关性，IL-6、IL-8、TNF—α与Neu／Leu％均呈正相关（P〈0．05）。结论血清IL-6、IL-8、TNF—α不仅参与了老年COPD急性加重的发病机制，而且与病情严重程度密切相关。

Objective To investigate the change and clinical significance of serum levels of interleukin-6 （IL-6） , IL-8 and tumor necrosis factor-or （TNF-α） in elderly patients with chronic obstructive pulmonary disease （COPD）. Methods Twenty-one cases with acute episodes COPD （AECOPD） hospitalized in the department of respiration were enrolled. Serum sample of all these cases in acute episode and the remission period after treatment for 10-14 days were observed. The pulmonary function and the ratio of neutrophils/leukocytes（ Neu/Leu% ） were tested in all these cases. The levels of IL-6, IL-8, TNF-α in serum were determined by immunoassay. Results The levels of Neu/Leu%, IL-6, IL-8 and TNF-α were decreased obviously in remission period （P 〈0. 01 ）, while FEVI Pre was significantly lower in AECOPD than in remission period （P 〈 0. 01 ）. The levels of IL-8, IL-6 and TNF-α presented notably negative correlation to FEV1 Pre （P 〈0. 05）. The levels of IL-8 ,IL-6 and TNF-α presented notably positive correlation to Neu/Leu% （P 〈0. 05）. There was not any correlation between Neu/Leu% and FEV1Pre（P 〉 0.05 ）. Conclusions IL-6, IL-8 and TNF-α in serum participate in the occurrence of COPD in elderly patients. The serum levels of IL-6, IL-8 and TNF-α are correlated with severity of the disease.