稳定期慢性阻塞性肺疾病治疗后炎症介质反应及临床病情的研究

Study on inflammatory mediators and clinical condition after treatment in patients with chronic obstructive pulmonary disease of stable phase

目的通过对稳定期阻塞性肺疾病阻塞性肺疾病(COPD)治疗后炎症介质标记物以及COPD分级与气流阻塞程度情况与健康人群对照研究,为临床治疗稳定期COPD提供进一步指导。方法选择2012年1月至2014年1月收治的60例稳定期COPD患者作为观察组,同时募集40例年龄匹配的健康体检者作为对照组。观察组患者进行规律吸入长效支气管舒张剂与吸入肾上腺皮质激素的基础治疗,半年后比较两组患者炎症介质标记物的水平[血清表面活性蛋白D(SPD)、Clara细胞分泌蛋白(CC)-16、血清基质金属蛋白酶(MMP)-9、基质金属蛋白酶组织型抑制剂-1(TIMP-1)]以及COPD分级及气流阻塞程度情况。结果与健康对照组相比,COPD患者血清中SPD显著升高(P<0.05),CC-16水平显著下降(P<0.05),MMP-9水平显著升高(P<0.05),TIMP-1水平显著升高(P<0.01)。观察组、对照组呼吸困难评分分别为(3.4±0.6)分、(3.7±0.7)分,两组比较差异有统计学意义(P<0.05);治疗后,观察组、对照组圣乔治呼吸问卷评分总分分别为(29.7±9.8)分、(54.3±17.9)分,两组比较差异有统计学意义(P<0.01)。结论通过对稳定期COPD治疗后炎症介质标记物以及COPD分级及气流阻塞程度情况与健康人群对照研究,为临床治疗稳定期COPD提供依据,为药物及康复治疗提供参考。

Objective To investigate the inflammatory mediators, COPD staging and airflow obstruction after therapy in patients with chronic obstructive pulmonary disease （COPD） of stable phase in order to provide thrther guidance for clinical treatment of COPD. Methods A total of 60 COPD patients in stable phase treated in our hospital between January 2012 amt January 2014 were selected as observation group,and matched 40 healthy peoples in physical examination were selected as control group. The based therapy of inhaled long-acting bronchodilators and adrenoeortical hormone were regularly given in observation group. Six months after treatment, the markers of inflammatory mediators including serum surface active pro- tein D （ SPD）, Clara cell secretory protein（CC） -16, matrix metMloproteinasc（MMP） -9, matrix metalloproteinases tissue in- hibitors（TIMP）-I amt COPD stages, airflow obstruction degree were compared between two groups. Results Compared with control group, serum SPD level increased significantly （ P 〈 0.05 ） , CC-16 level decreased significantly （ P 〈 0.05 ） , MMP-9 level increased significantly（ P 〈0.05 ） ,TIMP-1 level increased significantly in observation group（ P 〈0.01 ）. The Dyspnea scores [ （ 3.4±0.6 ） vs （ 3.7 ± 0.7 ）, P 〈 0.05 ], the St. GeorgeTs respiratory questionnaire （ SGRQ ） scores [ （ 29.7 ± 9. 8） vs （ 54.3 ± 17.9 ） , P 〈 0.01 ] in observation group were all significantly lower than those in control group. Conclusion The controlled trial of inflammatory mediators, COPD staging and airflow obstruction M）er therapy in the patients witb COPD in stable stage and healthy peoples provides further guidance of treating drugs and rehabilitation for clinical treatment of COPD.