慢性阻塞性肺疾病患者血清sICAM-1、炎性介质的检测及临床意义

The clinical significance of detection serum sICAM-1,inflammatory mediators levels of patients with chronic obstructive pulmonary disease

目的观察和分析慢性阻塞性肺疾病(COPD)患者血清可溶性细胞间黏附分子-1(sICAM-1)、炎性因子检测的临床意义。方法选取COPD急性加重期(AECOPD)患者60例作为AECOPD组,根据治疗前是否合并呼吸衰竭将其分为合并呼衰组和未合并呼衰组2个亚组;选取同期经常规治疗临床症状缓解的AECOPD患者60例作为COPD稳定期组;选取同期体检结果健康者60例作为对照组。对3组研究对象的血清sICAM-1、白细胞介素-10(IL-10)、白细胞介素-18(IL-18)水平进行检测和分析。结果 AECOPD组患者的血清sICAM-1和IL-18水平显著高于COPD稳定期组(P<0.05);COPD稳定期组患者的血清sICAM-1和IL-18水平显著高于对照组(P<0.05);AECOPD组患者的血清IL-10水平显著低于COPD稳定期组(P<0.05);COPD稳定期组患者的血清IL-10水平显著低于对照组(P<0.05);合并呼衰组患者的血清sICAM-1和IL-18水平显著高于未合并呼衰组(P<0.05);合并呼衰组患者的血清IL-10水平显著低于未合并呼衰组(P<0.05);AECOPD组患者的血清IL-10水平与血清sICAM-1水平呈负相关关系(r=-0.53,P<0.05),而AECOPD组患者的血清IL-18水平与血清sICAM-1水平呈正相关关系(r=0.68,P<0.05)。结论血清sICAM-1和IL-18水平的上升以及血清IL-10水平的下降可能与AECOPD的发生及其合并呼吸衰竭有相关性,血清sICAM-1水平的上升可反映患者机体炎性反应的加剧状态。

Objective To observe and analyze clinical significance of detection of serum soluble intracellular adhesion molecule-1（ sICAM-1）,inflammatory mediators levels for the patients with chronic obstructive pulmonary disease（ COPD）. Methods 60 patients with acute exacerbated COPD were selected as the AECOPD group and divided into complicated with respiratory failure group and the without complicated respiratory failure group according to whether the patients had been complicated with respiratory failure before the treatment; 60 patients with AECOPD whose clinical symptoms were relieved after the routine treatment during the same period were selected as the COPD stable phase group; 60 patients with healthy examination results during the same period were selected as the control group. The serum levels of sICAM-1,interleukin-10（ IL-10）,interleukin-18（ IL-18） of the subjects in the three groups were detected and analyzed. Results The serum sICAM-1 and IL-18 levels of the patients in the AECOPD group were significantly higher than those of the COPD stable phase group（ P〈 0. 05） and the serum sICAM-1 and IL-18 levels of the patients in the COPD stable phase group were significantly higher than those of the control group（ P〈 0. 05）; The serum IL-10 level of the patients in the AECOPD group was significantly lower than that of the COPD stable phase group（ P〈 0. 05） and the serum IL-10 level of the patients in the COPD stable phase group was significantly lower than that of the control group（ P〈 0. 0 5）; The serum sICAM-1 and IL-1 8 levels of the patients in the complicated with respiratory failure group were significantly higher than those of the without complicated respiratory failure group（ P〈 0. 05） and the serum IL-10 level of the patients in the complicated with respiratory failure group was significantly lower thanthat of the without complicated respiratory failure group（ P〈 0.05）; In the AECOPD group,the serum IL-10 level was negative related with the serum sICAM-1 level of（ r =- 0. 53,P〈 0. 05）,while the serum IL-18 level was positively related with the serum sICAM-1 level（ r = 0. 68,P〈 0. 05）. Conclusion The increased serum sICAM-1 and IL-18 levels and the decreased serum IL-10 level may be associated with the occurrence of AECOPD and the complicated respiratory failure. The increasing of the serum sICAM-1 level can reflect the state of the inflammatory reaction of patients.