血清炎性因子表达与慢性阻塞性肺疾病肺部感染BODE指数的关系

Relationship between expression of serum inflammatory factors and BODE index of patients with chronic obstructive pulmonary disease

目的探讨白介素-6（IL-6）、肿瘤坏死因子-α（TNF-α）及干扰素-γ（INF-γ）表达与慢性阻塞性肺疾病（COPD）肺部感染患者BODE指数的相关性,为后期诊疗提供参考。方法选取2013年6月-2014年11月医院收治的130例COPD合并肺部感染患者为研究对象,并将其归入研究组;将同期入院体检的90名健康志愿者纳入对照组;两组受试者均采用酶联免疫吸附试验法（ELISA法）行TNF-α、INF-γ检验,采用双抗体夹心ELISA法行IL-6检验,详细记录并对比检验结果;采用Pearson相关分析法及Spearman法分析上述指标同BODE指数的相关性。结果 BODE指数分级A组为2~4级的患者IL-6、TNF-α、INF-γ等炎性因子水平均显著高于B组受试者,差异有统计学意义（P〈0.05）;IL-6、TNF-α、INF-γ等炎性因子均同体质指数（BMI）不相关,但同呼吸困难量表（MMRC）呈正相关性,同第1秒用力呼气容积占预计值百分比（FEV1%）、6min距离（6MWD）呈负相关性。结论血清IL-6、TNF-α、INF-γ等炎性因子表达水平均同COPD肺部感染患者的BODE指数呈相关性,临床可将其作为评估患者病情发展、预测其预后质量的重要依据,全面提升诊疗针对性及有效性。

OBJECTIVE To explore the relationship between the expression of interleukin-6（IL-6）,tumor necrosis factor-α（TNF-α）,and interferon-γ（INF-γ）and the BODE index of the patients with chronic obstructive pulmonary disease（COPD）so as to provide guidance for the late treatment.METHODS A total of 130 COPD patients complicated with pulmonary infections who were treated in the hospitals from Jun 2013 to Nov 2014 were recruited as the study objects and assigned as the study group,meanwhile,90 healthy volunteers who received the physical examination were set as the control group.The TNF-αand INF-γof the two groups of participants were detected by using enzyme-linked immunosorbent assay（ELISA）method,the IL-6was detected with the use of double antibody sandwich ELISA method,and the detection results were recorded in detail.The correlation between the above indicators and the BODE index was observed by means of Pearson correlation analysis and Spearman analysis.RESULTS According to the BODE index grading,the levels of IL-6,TNF-αand INF-γof the patients with grade2-4were significantly higher in the group A than in the group B（P〈0.05）;the body mass index（BMI）was not correlated with the IL-6,TNF-α,or INF-γ,which,however,was positively correlated with MMRC dyspnea scale and was negatively correlated with the percentage of the first one second forced expiratory volume in predicated value（FEV1%）and the 6minutes walking distance（6MWD）.CONCLUSIONThe levels of the serum IL-6,TNF-α,and INF-γshow the correlation with the BODE index of the COPD patients complicated with pulmonary infections,and they can be used as the clinical indicators for evaluation of the development of illness condition and prediction of prognosis so as to comprehensively improve the effectiveness of diagnosis and treatment.