维生素D对稳定期慢性阻塞性肺疾病患者肺泡灌洗液中白介素因子、肿瘤坏死因子-α的影响

The effect of Vitamin D on interleukin and TNF-α levels in bronchoalveolar lavage fluid of patients with stable chronic obstructive pulmonary disease

目的研究慢性阻塞性肺疾病（chronic obstructive pulmonary diseases,COPD）稳定期患者服用不同剂量的维生素D对患者肺泡灌洗液白细胞介素6、8、17（IL-6、IL-8、IL-17）、肿瘤坏死因子-α（TNF-α）的影响及其对肺功能的影响。方法选取COPD稳定期患者100例（COPD组）,分为A、B两组,每组50例,同期门诊体检无异常的中老年健康体检者50例为对照（对照组）。以酶联免疫吸附法（ELISA）检测治疗前后肺泡灌洗液IL-6、IL-8、IL-17、TNF-α水平,肺功能的变化。使用SPSS 18.0软件,采用χ~2检验和t检验进行数据处理。结果治疗前,试验组肺泡灌洗液中IL-6、IL-8、IL-17、TNF-α高于对照组,差异有统计学意义（P〈0.01）。试验组A和试验组B,治疗后肺泡灌洗液中IL-6、IL-8、IL-17、TNF-α明显低于治疗前,差异有统计学意义（P〈0.01）,对照组治疗前后IL-6、IL-8、IL-17、TNF-α差异无统计学意义（P〉0.05）。同时,试验组A与试验组B比较,治疗后肺泡灌洗液中IL-6、IL-8、IL-17、TNF-α差异无统计学意义（P〉0.05）。试验组A和试验组B治疗前后第1秒用力呼气空积（FEV1）、用力肺活量（FVC）、FVC相比,差异有统计学意义（P〈0.05）,对照组治疗前后肺功能FEV1/FVC、FVC差异无统计学意义（P〉0.05）。结论 COPD稳定期患者的气道仍然存在慢性炎症,维生素D能通过降低稳定期COPD患者气道中的炎症因子IL-6、IL-8、IL-17和TNF-α等起到抗炎作用,从而延缓COPD患者的肺功能下降。

Objective To explore the effect of Vitamin D on interleukin and TNF-αlevels in bronchoalveolar lavage（BAL）fluid of patients with stable chronic obstructive pulmonary disease（COPD）.as well as the effect on lung function. Methods 100 patients with stable COPD were enrolled in the study and evenly divided into two groups,group A and B,who received Vitamin D 0.25 ug and 0.5ug twice a day for a year.Meanwhile 50 healthy middle-aged and the elderly were recruited in the study as control group receiving 0.25 ug Vitamin D.ELISA was used to determine the levels of IL-6,IL-8,IL-17 and TNF-αin BAL before and after Vitamin D treatment.And lung function was also tested.Chi-square test and t test were used for data analysis by software SPSS 18.0. Results Before treatment,the levels of IL-6,IL-8,IL-17 and TNF-αin BAL of patients with COPD were much higher than those in control group（P〈0.01）,and they significantly decreased in BAL of patients after Vitamin D treatment（P〈0.01）,while there were no change in control group（P〈0.05）.There was no significant difference of BAL levels of IL-6,IL-8,IL-17 and TNF-αafter the treatment between group A and B（P〈0.05）.The differences of FEV1/FVC and FVC before and after the treatment were only significant in group A and B（P〈0.05）,not in control group（P〈0.05）. Conclusions Vitamin D may have anti-inflammation effect by reducing the levels of IL-6,IL-8,IL-17 and TNF-αin the airway of patients with stable COPD and delays the decrease of lung function.