老年阻塞性肺疾病急性加重期患者诱导痰及血清中IL-8和IL-10的比较

Comparison of IL-8 and IL-10 in induced sputum and serum in elderly patients with acute stage of chronic obstructive pulmonary disease

目的观察AECOPD患者诱导痰和血液中IL-8、IL-10的变化。方法同步收集132例患者治疗前后的诱导痰和静脉血,检测IL-8、IL-10水平,并进行相关性分析;随机将患者分为4组,观察各组缓解天数,比较不同治疗组IL-8、IL-10变化水平。结果 AECOPD患者诱导痰上清液IL-8、IL-10浓度显著高于血清(P<0.001),治疗后组间诱导痰上清液IL-8水平差异有统计学意义(P<0.001)。使用激素治疗的两组诱导痰IL-10浓度治疗前后差异有统计学意义(P<0.05),诱导痰与血清的IL-10水平具有相关性(P<0.05)。好转组与非好转组治疗前血清IL-8浓度差异有统计学意义(P<0.001)。结论 AECOPD患者气道局部炎症较全身炎症显著,血清IL-8有助于预后的评估。吸入激素可以有效提高气道局部IL-10水平,降低IL-8水平。

Objective To determine the correlation of interleukin-8 and interleukin-10 level in induced sputum and serum in elderly patients with acute exacerbations of chronic obstructive pulmonary disease,and to evaluate the effect of corticosteroid in treatment of this disease.Methods The induced sputum and peripheral vein blood samples were taken from 132 AECOPD cases simultaneously for examining and analyzing of the level of IL-8 and IL-10.132 subjects were randomly divided into four groups.The remission period,medical expenditure,induced sputum and serum interleukin-8 and interleukin-10 levels after treatment in these groups were compared.Results The levels of IL-8 and IL-10 in induced sputum were significantly higher than those in serum（P0.001）.After treatment,the level of IL-8 in induced sputum was statistically and significantly changed in each group（P0.001）.The two groups treated with corticosteroid showed statistical difference（P0.005）.Serum level of IL-10 was positively correlated with that of sputum level in patients with AECOPD（P0.05）.In improvement group,the level of IL-8 in serum was significantly lower than that in non-improvement group（P0.001）.Conclusion It is indicated that within acute aggravating stage of chronic obstructive pulmonary disease,patients＇airway inflammation is more serious than systematic inflammation.The level of IL-8 in serum can be helpful for evaluation of prognosis in AECOPD.Treatment with inhaled corticosteroid is a method to increase the local expression of IL-10 and decrease the local expression of IL-8,but helpless for systematic inflammation.Serum level of IL-10 was positively correlated with sputum level in patients with AECOPD.It may be taken for granted that they had the same source.