HIF-1α在老年重度COPD稳定期患者中的变化及意义

The change and significance of HIF-1α with joint aerosol therapy in elderly severe patients with stable COPD

目的探讨缺氧诱导因子-1α(HIF-1α)在联合气雾剂治疗老年重度慢性阻塞性肺疾病(COPD)稳定期患者中的变化及临床意义。方法 84例老年重度COPD稳定期患者作为观察组,将其随机分为2组,观察组1予以常规治疗,观察组2在观察组1基础上联合吸入噻托溴铵及沙美特罗/氟替卡松3个月。与38例健康老人相比,比较观察组患者血清HIF-1α、IL-8水平及肺功能指标(第1秒用力呼气容积FEV1、FEV1占预计值百分比)的变化。结果①对照组、观察组1、观察组2 HIF-1α水平分别为(43.33±10.42)pg/ml、(140.23±17.43)pg/ml、(72.56±9.67)pg/ml,观察组1、观察组2与对照组之间差异有统计学意义(P均<0.05),观察组2与观察组1之间差异有统计学意义(P<0.05)。②对照组、观察组1、观察组2 IL-8水平分别为(65.31±8.98)pg/ml、(96.11±17.47)pg/ml、(73.58±11.25)pg/ml,观察组1、观察组2与对照组之间差异有统计学意义(P均<0.05),观察组2与观察组1之间差异有统计学意义(P<0.05)。③对照组、观察组1、观察组2肺功能指标FEV1分别为(3.21±0.26)L、(1.26±0.17)L、(1.77±0.19)L,肺功能指标FEV1占预计值百分比分别为(88.87±5.73)%、(39.56±2.24)%、(52.63±3.63)%,观察组1、观察组2与对照组之间差异有统计学意义(P均<0.05),观察组2与观察组1之间差异有统计学意义(P<0.05)。④HIF-1α水平与IL-8水平呈正相关,与肺功能呈负相关。结论HIF-1α、IL-8的变化是观察COPD患者病情严重程度及治疗效果的较好的实验室参数。

Objective To investigate the change and significance of HIF-1 cL with joint aerosol therapy in elderly severe patients with stable COPD. Methods Eighty-four elderly severe patients with stable chronic obstructive pulmonary dis- ease were investigated as group 1 and group 2, thirty-eight elderly healthy were investigated as control group. Conventional treatment in group 1, Group 2 were treated with conventional therapy and inhaled Tiotropium Bromide combined with Sal- meterol/Fluticasone for three months, then to Comparative observation group of patients serum HIF-1 c, IL-8 levels and pulmonary function index （forced expiratory volume in first second FEV1, FE1 percentage of expected value）. Results The level of HIF-lot in the control group, group 1 and group 2 were（43.33 ± 10.42 ）pg/ml, （140.23 ±17.43 ）pg/ml, （72.56 ± 9.67 ）pg/ml, significant difference between group 1, group 2 and control group （P 〈 0.05 ）, it was significant difference between group land group 2（ P 〈 0.05 ）. The level of IL-8 in the control group, group 1 and group 2 were （ 65.31 ：e 8.98 ） pg/ml, （ 96. 11 .＋ 17.47 ） pg/ml, （ 73.58 _＋ 11.25 ） pg/ml, significant difference between observation group 1, group 2 and control group （ P 〈 0.05 ）, it was significant difference between group 1 and group 2 （ P 〈 O. 05 ）. Lung function indices FEV1 in the control group, groupl and group 2 were （ 3.21 ± 0.26） L, （ 1.26 ± O. 17 ） L, （ 1.77 ±O. 19 ）L,lung function indices FEV1 percentage of expected value in the control group, group 1 and group 2 were（ 88.87 ± 5.73 ）%, （39.56 ± 2.24 ）%, （52.63 ± 3.63 ）%, significant difference between observation group 1, group 2 and control group（ P 〈 0.05 ）, it was significant difference between group 1 and group 2（ P 〈 0.05 ）. The levels of HIF-lot and IL-8 were positively correlated, and negatively correlated with lung function. Conclusion The change of HIF-1 ct and IL-8 was the better laboratory parameters to observe illness severity and the treatment effect of COPD patients.