稳定期COPD患者全身炎症水平与GOLD分级及BODE指数关系的研究

Study on the relationship between systemic inflammation and GOLD classification and BODE index in stable COPD patients

目的分析稳定期慢性阻塞性肺疾病(COPD)患者全身炎症反应指标(IL-6、IL-8、TNF-α、hs-CRP、FIB)水平与GOLD分级及BODE指数的相关性。方法收集2014年11月~2016年12月我院收治的符合要求的50例稳定期COPD患者,测量其白介素-6(interleukin-6,IL-6)、白介素-8(interleukin-8,IL-8)、肿瘤坏死因子ɑ(tumor necrosis factor-ɑ,TNF-ɑ)、超敏C反应蛋白(hypersensitivity C reactive protein,hs-CRP)、纤维蛋白原(fibrinogen,FIB)水平,与同期健康吸烟者(对照组)进行比较,同时评估GOLD分级及BODE指数,分析其与IL-6、IL-8、TNF-α、hs-CRP、FIB的相关性。结果 COPD患者外周血内IL-6、IL-8、TNF-α、hs-CRP以及FIB水平均较对照组高(均P<0.05),随BODE分数水平升高呈上升趋势;IL-6、IL-8、TNF-α、hs-CRP、FIB水平与BODE指数呈显著正相关(均P<0.05);COPD患者的BODE指数分级与GOLD分级呈显著正相关(P<0.05)。结论 IL-6、IL-8、TNF-α、hs-CRP、FIB等炎性因子表达水平均与COPD患者的BODE指数呈正相关性,能够成为临床评估患者病情发展以及预测预后质量的关键指标。

Objective To analyze the correlation between systemic inflammatory response indexes（IL-6, IL-8, TNF-α,hs-CRP, FIB） and GOLD classification and BODE index in patients with stable chronic obstructive pulmonary disease（COPD）. Methods 50 patients with stable COPD who were admitted in our hospital from November 2014 to December2016 were enrolled in this study. The levels of Interleukin-6（IL-6）, Interleukin-8（IL-8）,tumor necrosis factor-ɑ（TNF-ɑ）,hypersensitivity C reactive protein（hs-CRP） and fibrinogen（FIB） were detected. The patients were compared with healthy smokers in the same period（control group）. The GOLD classification and BODE index were assessed, and their relationship between IL-6, IL-8, TNF-α, hs-CRP and FIB was analyzed. Results The levels of IL-6, IL-8, TNF-α,hs-CRP and FIB in peripheral blood of COPD patients were higher than those of control group（P〈0.05）, and increased with the level of BODE score. The levels of IL-8, TNF-α, hs-CRP and FIB were positively correlated with BODE index（P〈0.05）. There was a significant positive correlation between BODE index and GOLD grade in COPD patients（P〈0.05）. Conclusion The expression of inflammatory factors including IL-6, IL-8, TNF-α, hs-CRP and FIB are positively correlated with the BODE index of COPD patients, which can be the key index to evaluate the disease progression and predict the prognosis qualityof patients.