慢性阻塞性肺疾病合并肺动脉高压患者血清及呼出气冷凝液中炎症因子含量检测的临床意义

Clinical significance of serum and exhaled breath condensate inflammatory cytokine levels in chronic obstructive pulmonary disease patients complicated with pulmonary hypertension

目的分析慢性阻塞性肺疾病(COPD)合并肺动脉高压患者血清及呼出气冷凝液(EBC)中炎症因子含量及其临床意义。方法选择在吉林油田总医院接受住院治疗的单纯COPD患者和COPD合并肺动脉高压患者作为研究对象,比较两组患者的血清及呼出气冷凝液中炎症因子含量差异。按照肺动脉压力水平进一步将COPD合并肺动脉高压患者分为低压组、中压组、高压组,测定三组患者的血清及呼出气冷凝液中炎症因子含量水平并分析炎症因子水平与肺动脉高压的相关性。结果观察组患者的血清及EBC中IL-6、hs-CRP水平高于对照组,IL-10水平低于对照组(P<0.05)。肺动脉高压三组间血清及EBC中炎症因子水平有差异(P<0.05)。肺动脉高压越严重,血清及呼出气冷凝液中IL-6及hs-CRP含量越高,IL-10含量越低(P<0.05)。血清及呼出气冷凝液中IL-6、hs-CRP水平与COPD患者的肺动脉高压严重程度呈正比,IL-10水平与COPD患者的肺动脉高压严重程度呈反比(P<0.05)。结论 COPD合并肺动脉高压患者血清及呼出气冷凝液中促炎因子水平较高,且炎症因子水平与肺动脉高压程度呈正相关。

[Objective]To analyze the clinical significance of serum and exhaled breath condensate（EBC） inflammatory cytokine levels in chronic obstructive pulmonary disease（COPD） patients complicated with pulmonary hypertension（PH）.[Methods]Sixty-nine patients with single COPD（control group） and seventy-three cases of COPD complicated with pulmonary hypertension（observation group） in our hospital were chosen as research subjects. The serum and EBC inflammatory cytokine levels were compared between both groups. According to the level of pulmonary artery pressure, the patients with COPD complicated with PH were further divided into low pressure, medium pressure and high pressure subgroups. The serum and EBC inflammatory factor levels and their relationships with pulmonary artery pressure were analyzed.[Results]The serum and EBC IL-6 and hypersensitive c-reactive protein（hs-CRP） levels in the observation group were higher than those in the control group, while IL-10 level was lower（P〈0.05）. There were significant differences in the serum and EBC inflammatory factor levels among the three subgroups with pulmonary hypertension（P〈0.05）. The severer the pulmonary hypertension was, the higher the levels of hs-CRP and IL-6 were, and the lower the level of IL-10 was（P〈0.05）. The levels of IL-6 and hs-CRP were positively correlated with the severity of pulmonary hypertension, while the level of IL-10 was negatively correlated（P〈0.05）.[Conclusions]The inflammatory factors in serum and EBC of patients with COPD complicated with PH are of high level, and the levels of inflammatory factors are in positive correlation with the severity of pulmonary hypertension.