炎性反应因子和纤维蛋白原联合检测在慢性阻塞性肺疾病中的应用

Application of inflammatory factor and fibrinogen detection in chronic obstructive pulmonary disease

目的探讨血清炎性反应因子联合纤维蛋白原在慢性阻塞性肺疾病(COPD)患者中的水平变化,并探讨其与感染细菌类型的关系。方法选取石家庄市中医院老年病科收治的50例COPD患者作为观察组,以50例支气管炎患者作为阳性对照组,测定血清炎性反应因子白细胞介素(IL)-6、IL-8和纤维蛋白原水平,另选取同期在石家庄市中医院体检的健康人50例作为阴性对照组,观察血清学指标与肺功能指标的关系,并对患者进行3年随访,观察其与预后的关系。结果 COPD患者血清IL-6、IL-8和纤维蛋白原水平分别为(5.9±0.8)pg/mL、(14.7±4.4)pg/mL、(496.4±87.1)mg/dL,明显高于健康人的[(1.6±0.8)pg/mL、(3.2±0.7)pg/mL、(219.4±23.7)mg/dL]和支气管炎组的[(4.6±0.9)pg/mL、(11.2±4.1)pg/mL、(376.2±81.6)mg/dL],其差异均有统计学意义(t=2.18、3.12、3.22;P=0.01、0.01、0.01)。IL-6、IL-8和纤维蛋白原水平越高,肺功能指标越差,其相关性系数为0.73、0.68、0.70,差异有统计学意义(P<0.05);随访3年后,存活组患者血清IL-6、IL-8和纤维蛋白原水平分别为(5.31±0.22)pg/mL、(11.08±0.42)pg/mL、(310.87±112.09)mg/dL;均低于死亡组的(12.08±0.25)pg/mL、(21.64±5.16)pg/mL、(550.35±135.82)mg/dL,其差异有统计学意义(t=3.18、3.28、2.46;P=0.01、0.01、0.01)。结论血清炎性反应因子IL-6、IL-8和纤维蛋白原联合检测可以明确诊断COPD,同时间接判断肺功能和预后,具有重要临床意义。

Objective To investigate the value of serum fibrinogen combined with inflammatory cytokines in the patients with chronic obstructive pulmonary disease（COPD）,and to explore its relationship with theinfection of bacteria types.Methods Retrospective analysis was used in this study,50 patients with COPD and 50 patients with bronchitis treated in hospital were selectd as the observation group and the positive control group.The serum inflammatory cytokines IL-6,IL-8 and fibrinogen were detected.In addition,50 healthy elderly in hospital in the same period were selected as the negative control group.The relationship between the serum and lung function index were observed.All the cases were followed up for three years.Its relationship with the prognosis was observed.Results The levels of serum IL-6,IL-8and fibrinogen in observation group were（5.9±0.8）pg/mL,（14.7±4.4）pg/mL,（496.4±87.1）mg/dL,significantly higher than in negative control group[（1.6±0.8）pg/mL,（3.2±0.7）pg/mL,（219.4±23.7）mg/dL],and the positive control group[（4.6±0.9）pg/mL,（11.2±4.1）pg/mL,（376.2±81.6）mg/dL],the difference was statistically significant（t=2.18,3.12,3.22;P=0.01,0.01,0.01）.The IL-6,IL-8and fibrinogen levels were higher,the worse lung function index,the correlation coefficient was 0.73,0.68,0.70,the difference was statistically significant（P〈0.05）.After follow-up for 3years,the serum levels of PG,IL-8and fibrinogen in survival group were（5.31±0.22）pg/mL,（11.08±0.42）pg/mL,（310.87±112.09）mg/dL,which was lower than in death group[（12.08±0.25）pg/mL,（21.64±5.16）pg/mL,（550.35±135.82）mg/dL],the difference was statistically significant（t=3.18,3.28,2.46,P=0.01,0.01,0.01）.Conclusion The serum levels of inflammatory cytokines IL-6,IL-8 and fibrinogen detection can diagnose COPD,and indirectly judge the pulmonary function and prognosis.