系统性炎症与慢性阻塞性肺疾病大动脉弹性的相关性研究

Relationship between systemic inflammation and the chronic obstructive pulmonary disease of arterial elasticity

目的探讨慢性阻塞性肺疾病（COPD）患者系统性炎症与大动脉弹性之间的关系。方法采用病例对照研究的方法，研究对象分为两组：病例组：102例COPD稳定期患者；对照组：83例同期健康体检者。两组研究对象用同样的方法应用脉搏波速度自动测定仪测定颈-股动脉搏波传导速度（C—FPwV）和颈-足背动脉搏波传导速度（C—DPWV）作为大动脉弹性的参数，应用免疫比浊法测定血清超敏C反应蛋白（hs—CRP）浓度，放射免疫分析法测定血清白介素1（IL-1）、白介素6（IL-6）、肿瘤坏死因子α（TNF—α）浓度，这些炎性因子的测定作为系统性炎症的参数，与正常对照组作比较。结果①病例组C-FPWV、C—DPWV、IL-1、IL-6、TNF—α、hs—CRP均高于正常对照组，差异有统计学意义，P〈0．05。②病例组C—FPWV与年龄、吸烟指数、收缩压、IL-1、IL-6、TNF—α、hs—CRP呈正相关，P〈0．05。C—DPWV与年龄、吸烟指数、IL-1、IL-6、TNF—α、hs—CRP呈正相关，P〈0．05。③IL-6、吸烟指数、TNF-α是影响C—FPWV的独立因素；IL-6是影响C—DPWV的独立因素。结论系统性炎症与COPD患者大动脉弹性间存在相关性。系统性炎症可能参与了COPD患者大动脉弹性下降的发病过程，它是COPD患者发生心血管疾病的高危因素。

Objective To investigate the correlation between the systemic inflammation and arterial elasticity with chronic obstructive pulmonary disease （COPD）. Methods A case-control study, subjects were divided into two groups ： case group ： 102 patients with stable COPD patients, control group ; 83 cases of healthy persons over the same period. Two groups of subjects using the same method applied automatic pulse wave velocity determined by measuring carotid-femoral pulse wave velocity （C-FPWV） and cervical- dorsal arterial pulse wave velocity （C-DPWV） as the main artery elastic parameters. Serum tumor necrosis factor-α （TNF-α） measured by immunoturbidimetry and serum interleukin-1 （IL-1）, IL-6, TNF-α measured by radioimmunoassay. Determination of these inflammatory mediators as parameters of systemic inflammation, compared with normal control group. Results （1）Case group C-FPWV, C-DPWV, IL-1, IL-6 ,TNF-α,hs-CRP higher than the control group, the difference was statistically significant P 〈0.05.（2）Case group C-FPWV with age, smoking index, systolic blood pressure, IL-1, IL-6, TNF-α, hs-CRP was positively correlated with P〈0.05. C-DPWV with age, smoking index, IL-1, IL-6, TNF-α, hs-CRP was positively correlated with P 〈0.05. （3）IL-6, smoking index （years of support）, TNF-α is an independent factors of C-FPWV and IL-6 is an independent factors of C-DPWV. Conclusions Systemic inflammation associated with arterial elasticity in patients with COPD. Systemic inflammation may be involved in the pathogenesis of decreased arterial elasticity in COPD patients. Systemic inflammation is a risk factor for cardiovascular disease in patients with COPD.