COPD治疗期间呼出气冷凝液中细胞因子的变化及意义

Change and significance of cytokines in exhaled breath condensate in COPD patients during treatment

目的探讨COPD患者治疗期间呼出气冷凝液(EBC)细胞因子水平的变化及与肺功能相关性。方法入选稳定期COPD组24例,健康对照组18例。治疗前及治疗2周、4周、12周收集EBC并检测其LTB4、TNF-α、IL-13水平,并行肺功能检查。结果治疗前COPD组EBC中LTB4、TNF-α、IL-13水平高于对照组,治疗2周后均下降,治疗4周LTB4进一步下降(P<0.05),且至12周保持低水平;而TNF-α、IL-13在治疗后2周至12周水平未见明显变化;治疗前后肺功能比较差异有统计学意义(P<0.05);治疗前FEV1%与LTB4呈负相关关系(r=-0.574,P=0.003)。结论 LTB4、TNF-α可能参与COPD发病机制,可作为治疗期间观察疗效及监测病情指标。

Objective To investigate the change of cytokines in exhaled breath condensate in COPD patients during treatment and its relationship with pulmonary function. Methods The study selected 24 patients with stable COPD as the study group and 18 healthy people as the control group. EBC was collected from each patient before and 2, 4, and 12 weeks after the treatment. The concentrations of LTB4 , TNF-αand IL-13 were measured. Meanwhile, lung function was performed before and after therapy. Results The levels of LTB4 , TNF-α and IL-13 in EBC were higher in the study group than in the control group, and still decreased significantly 2 and 4 weeks after the treatment （P〈0. 05）. The level of TNF-αand IL-13 did not change significantly in the following 4 and 12 weeks （P〉0. 05）. Changes of FEV1% and FEV1/FVC% before and after treatment had statistic significance. FEV1% pre was negative correlated with LTB4, （r= -0. 574, P=0. 003）. Conclusion LTB4 and TNF-α may involve in the process of in-flammatory reaction of COPD, and they may be biomarkers in observing drug effect and monitoring disease severity.