AECOPD患者治疗前后痰和血清IL-8、MMP-9的变化及其与肺功能的关系

Relationship between the Change of IL-8 and MMP-9 Levels in the Sputum/Serum and the Pulmonary Function in Patients with Acute Exacerbations of Chronic Obstructive Pulmonary Disease before and after Treatment

目的比较AECOPD患者治疗前后,痰和血清IL-8、MMP-9的浓度变化,并分析其浓度与肺功能的相关性.方法采集20例AECOPD患者入院和出院时血液和痰液作为研究对象,并做肺通气功能检测,同时选择15例健康人群抽取外周血作为对照,检测IL-8、MMP-9浓度,患者治疗前后进行对比,并与肺功能进行相关性分析.结果 (1)AECOPD患者治疗前血清IL-8浓度(28.30±14.39)pg/m L高于对照组(17.46±3.48)pg/m L,P=0.008,经治疗后显著下降(13.30±6.31)pg/m L,P=0.000;治疗前痰液IL-8浓度(639.40±703.12pg/m L)在治疗后显著下降(501.60±508.61)pg/m L,P=0.042.(2)AECOPD患者治疗前血清MMP-9浓度(1.12±0.36 ng/ml)低于对照组(17.89±11.00)ng/m L,P=0.000,经治疗后浓度显著下降[(0.87±0.31 ng/m L,P=0.000];治疗前痰液MMP-9浓度(12.04±12.22 ng/m L)在治疗后显著下降[(8.02±7.13)ng/m L,P=0.005].(3)AECOPD患者治疗前血清IL-8浓度与FEV1及FEV1/FVC均无显著相关性,痰液IL-8浓度与FEV1/FVC呈负相关(P<0.05),与FEV1无显著相关性(P>0.05);治疗后血清IL-8浓度与FEV1及FEV1/FVC均无显著相关性(P>0.05),痰液IL-8浓度与FEV1及FEV1/FVC均呈负相关(P<0.05).(4)AECOPD患者治疗前血清MMP-9浓度与FEV1及FEV1/FVC均无显著相关性,痰液MMP-9浓度与FEV1无显著相关性,与FEV1/FVC呈负相关(P<0.05);治疗后血清MMP-9浓度与FEV1及FEV1/FVC均无显著相关性,痰液MMP-9浓度与FEV1及FEV1/FVC均呈负相关(P<0.05).结论 COPD患者急性发作期血清和痰液中IL-8、MMP-9浓度高于稳定期患者和对照组.血清IL-8、MMP-9浓度与肺功能无显著相关性,痰液IL-8、MMP-9浓度与肺功能存在负相关,临床上可通过检测上述浓度值来评估病情严重程度.

Objective To compare the difference of IL-8 and MMP-9 levels in the serum and sputum before and after treatment in patients with acute exacerbations of COPD, and to analyze the correlation between IL-8 and MMP-9 levels and lung function. Method A total of 20 cases of AECOPD patients were randomly selected in the observation group and 15 cases of healthy people were selected in the control group. Pulmonary function was measured and the specimens of sputum and blood were collected during the admission and discharge for AECOPDpatients. FEV1 and FEV1/FVC% were recorded, and the concentration of IL-8 and MMP-9 in the sputum supernatant and serum were tested with double antibody sandwich enzyme linked immunosorbent assay before and after treatment. All the data and correlation were analyzed with t test and SPSS software. Results（1） Before the treatment,serum IL-8 concentration in COPD patients was 28.30±14.39 pg/mL, higher than that in the control group [17.46 ±3.48） pg/mL, P =0.008]. After treatment, the serum IL-8 concentration was significantly decreased [（13.30 ±6.31） pg/mL, P =0.000]. IL-8 concentration of sputum significantly decreased after treatment [（501.60± 508.61） pg/mL,P=0.042] than one before treatment（639.40±703.12） pg/mL.（2）Before treatment, serum MMP-9 concentration in patients with AECOPD was 1.12 ±0.36 ng/mL, lower than control group [（17.89±11.00） ng/mL,P=0.000）]. After treatment, the serum MMP-9 concentration was significantly decreased [（0.87 ±0.31） ng/mL, P=0.000]. MMP-9 concentration of sputum before treatment（12.04±12.22） ng/mL decreased significantly after treatment [（8.02±7.13） ng/mL,P=0.005].（3） Before treatment, no correlation was seen between the concentration of serum IL-8 and FEV1, FEV1/FVC. Negative correlation was observed between the sputum IL-8 concentration and FEV1/FVC and no correlation was found with FEV1. After treatment, we found that no correlation showed between the concentration of IL-8 and FEV1,FEV1/FVC, and negative correlation was seen between the IL-8 concentration in sputum and FEV1, FEV1/FVC.（4） Before treatment, no correlation between the concentration of serum MMP-9 and FEV1, FEV1/FVC was observed and no correlation between the sputum MMP-9 concentration with FEV1 was seen. Negatively correlation was found between the sputum MMP-9 level wtih FEV1/FVC. After treatment, we observed no correlation between the serum concentration of MMP-9 and FEV1, FEV1/FVC, and negative correlation between the concentration of MMP-9 in sputum and FEV1, FEV1/FVC. Conclusion The concentration of IL-8 and MMP-9 in serum and sputum in patients with acute exacerbation of COPD is higher than those in the stable phase. IL-8 and MMP-9 levels in serum show no correlation with lung function. Negative correlation was observed between IL-8 and MMP-9 levels in sputum and lung function. We can test the levels of IL-8 and MMP-9 in sputum to evaluate the severity of the disease.