慢性阻塞性肺疾病患者血尿酸和血清细胞因子水平测定的临床意义

The clinical significance of the detection of serum uric acid and serum cytokine levels in patients with chronic obstructive pulmonary disease

目的探讨慢性阻塞性肺疾病（COPD）患者血尿酸（uA）和血清细胞因子肿瘤坏死因子（TNF）-α、可溶性细胞间黏附分子（sICAM）-1、白细胞介素（IL）-6、IL-8水平测定的临床意义。方法40例健康体检者（对照组）和158例COPD患者（COPD组）在急性发作期和缓解期分别采用自动生化分析仪检测UA，ELISA法检测血清TNF-α、sICAM-1、IL-6、IL-8水平。采用肺功能仪检测COPD患者急性发作期和缓解期第1秒用力呼气容积占预计值百分比（FEv。％）。结果COPD组急性发作期TNF-α、sICAM-1、IL-6、IL-8和UA明显高于对照组（P〈0．01），FEV1％明显低于对照组（P〈0．01）；COPD组缓解期TNF-α、sICAM-1和uA明显高于对照组（P〈0．01或〈0．05），IL-6、IL-8与对照组比较差异无统计学意义（P〉0．05），FEV1％明显低于对照组（P〈0．01）。相关性分析显示，COPD患者急性发作期TNF-α、sICAM-1、IL-6、IL-8、UA与FEV1％呈负相关（r值分别为-0．681、-0．579．-0．545、-0．652、-0．357，P〈0．01或〈0．05）；缓解期TNF-α、sICAM-1、IL-6和IL-8与FEV，％呈负相关（r值分别为-0．623、-0．335、-0．349、-0．623，P〈0．01或〈0．05），UA与FEV。％无明显相关性（r值为-0．092，P〉0．05）。结论UA和血清细胞因子TNF-α、sICAM-1、IL-6、IL-8参与COPD的病情发展，与肺功能存在相关性，可以作为COPD病情的判断指标。

Objective To investigate the clinical significance of the detection of the levels of serum uric acid （UA） and serum cytokine tumor necrosis factor-α （TNF-α ）, soluble intercellular adhesion molecule-1 （sICAM-1）, interleukin （IL）-6 and IL-8 in patients with chronic obstructive pulmonary disease （COPD）. Methods UA of 40 healthy people （control group） and 158 COPD patients （COPD group） in acute exacerbation and remission stage was detected respectively by automatic biochemical analyzer, and the levels of serum TNF-α, sICAM-1, IL-6 and IL-8 were detected by ELISA. The percentage of first second forced expiratory volume in expected value （ FEV1% ） of COPD patients in acute exacerbation and remission stage were detected. Results TNF-ot , sICAM-1, IL-6, IL-8 and UA of C OPD group in acute exacerbation were significantly higher than those of control group （P 〈 0.01 ）, and FEVj% was significantly lower than that of control group （P 〈 0.01 ）. TNF- α, sICAM-1 and UA of COPD group in remission stage were significantly higher than those of control group （P 〈0.01 or 〈0.05）,IL-6 and IL-8 had no statistical significance compared with those of control group （P 〉 0.05 ）, and FEV1% was significantly lower than that of control group （P 〈 0.01 ）. Correlation analysis showed that TNF- α, sICAM-1, IL-6,1L-8, UA of COPD patients in acute exacerbation were negatively correlated with FEV1% （r =-0.681 ,-0.579,-0.545,-0.652,-0.357, respectively,P 〈 0.01 or 〈 0.05）. In remission stage,TNF- α, sICAM-1, IL-6 and IL-8 of COPD patients were negatively correlated with FEVI% （r = -0.623,-0.335,-0.349,-0.623,P 〈 0.01 or 〈 0.05）, and UA had no significant correlation with FEVj% （r =-0.092,P 〉0.05）. Conclusions The serum UA and cytokines TNF-α, slCAM-1, IL-6, IL-8 are involved in the progression of COPD and correlated with lung function. They can be used as the judge indexes of COPD.