慢性阻塞性肺疾病治疗期间呼出气冷凝液中炎症因子的变化及临床意义

Changes and clinical significance of inflammatory cytokines in exhaled breath condensate during treatment of chronic obstructive pulmonary disease

目的探讨慢性阻塞性肺疾病(COPD)治疗期间呼出气冷凝液(EBC)中白细胞介素-6(IL-6)、白细胞介素-8(IL-8)、白细胞介素-10(IL-10)、白细胞介素-17(IL-17)、人基质金属蛋白酶-9(MMP-9)的变化及临床意义。方法选择我院呼吸内科2016年1~10月期间收治的48例COPD稳定期患者为研究对象,同时选择45例健康体检者纳入对照组,比较两组受检者EBC中的IL-6、IL-8、IL-10、IL-17、MMP-9水平,对COPD患者治疗前后进行COPD评估测试(CAT)评分并比较。结果 COPD患者治疗前后EBC中的IL-6、IL-8、IL-17、MMP-9水平均明显高于对照组,IL-10明显低于对照组,差异均有统计学意义(P<0.05);COPD患者治疗后,EBC中的IL-6、IL-8、IL-17、MMP-9水平较治疗前明显降低,IL-10较治疗前明显升高,差异均有统计学意义(P<0.05);治疗后,COPD患者CAT评分为(18.14±2.02)分,明显低于治疗前的(21.18±2.15)分,差异有统计学意义(P<0.05);COPD患者EBC中的IL-6、IL-8、IL-17、MMP-9水平均与CAT评分呈正相关(P<0.05),IL-10则与CAT评分呈负相关(P<0.05)。结论监测EBC IL-6、IL-8、IL-10、IL-17及MMP-9水平变化可有效反映COPD患者的气道炎症反应程度,且炎症因子水平与生活质量具有相关性。

Objective To investigate the changes and clinical significance of interleukin 6 （IL-6）, IL-8, IL-10, IL-17 and human matrix metalloproteinase-9 （MMP-9） in exhaled breath condensate （EBC） during treatment of chronic obstructive pulmonary disease （COPD）. Methods Forty-eight cases of stable COPD patients treated in the respiratory department of our hospital from January 2016 to October 2016 were observed, and 45 healthy people underwent health examination during the same time were selected as control group. Comparison of two groups were explored on level of IL-6, IL-8, IL-10, IL-17, MMP-9 in EBC and scores of COPD assessment test （CAT） before and after treatment. Results Both pre-and post-treatment serum level of EBC IL-6, IL-8, IL-17, MMP-9 in COPD patients were signifi-cantly higher than those in control group, while IL-10 concentration was significantly lower in patients compared to con-trols （P〈0.05）. IL-6, IL-8, IL-17 and MMP-9 levels at post-treatment were significantly lower than at pre-treatment in EBC of COPD patients, and IL-10 concentration was significantly higher （P〈0.05）. The mean CAT score for the COPD patients after treatment was （18.14±2.02）, significantly below （21.18±2.15） before treatment （P〈0.05）. There was a posi-tive correlation of EBC IL-6, IL-8, IL-17, MMP-9 with CAT score in COPD patients （P〈0.05）, and a negative correla-tion between IL-10 and CAT score （P〈0.05）. Conclusion Monitoring the changes of EBC IL-6, IL-8, IL-10, IL-17 and MMP-9 levels may effectively reflect the degree of airway inflammation in COPD patients. There is a relationship between inflammatory factors level and quality of life.