支气管炎型与肺气肿型AECOPD患者血浆periostin、bFGF、TNF-α、IL-6、IL-8水平变化

PLASMA LEVELS OF PERIOSTIN,BFGF,TNF-Α,IL-6 AND IL-8 IN PATIENTS WITH BRONCHITIS AND EMPHYSEMA AECOPD

目的观察支气管炎型与肺气肿型慢性阻塞性肺疾病急性加重期(AECOPD)患者血浆periostin、bFGF、TNF-α、IL-6、IL-8水平变化,并探讨其临床意义。方法 AECOPD患者118例,其中支气管炎型58例(病例1组),肺气肿型60例(病例2组)。另选健康体检者58例为对照组。比较上述三组人群中血浆periostin、bFGF、TNF-α、IL-6、IL-8水平及肺功能。结果病例1组和病例2组血浆periostin、bFGF、TNF-α、IL-6、IL-8水平明显高于对照组,且病例2组血浆periostin、bFGF、TNF-α、IL-6、IL-8水平明显高于病例1组,差异具有统计学意义(P均<0.05)。病例1组和病例2组FEV1/FVC、FEV1%均低于对照组(P均<0.05),但病例2组肺功能下降更明显。COPD患者血浆periostin、bFGF、TNF-α、IL-6、IL-8分别与FEV1/FVC、FEV1%之间呈负相关关系。结论 Periostin、bFGF、TNF-α、IL-6、IL-8在肺气肿的形成过程及疾病进展中起了重要作用。肺气肿型AECOPD患者的肺功能较支气管炎型AECOPD患者预后更差。

Objective To observe the changes of plasma levels of periostin,bFGF,TNF-a,IL-6 and IL-8 in patients with acute exacerbation of chronic obstructive pulmonary disease（AECOPD）of bronchitis type and emphysema type,and to explore their clinical significance.Methods There were 118 patients with AECOPD,58 with bronchitis（case 1 group）and 60 with emphysema（case 2 group）.Another 58 healthy subjects were selected as control group.The plasma levels of Periostin,bFGF,TNF-,IL-6,IL-8 and lung function in the three groups were compared.Results The plasma levels of periostin,bFGF,TNF-a,IL-6 and IL-8 in case 1 and case 2 groups were significantly higher than those in control group,and the plasma levels of periostin,bFGF,TNF-a,IL-6 and IL-8 in case 2 were significantly higher than those in case 1（P〈0.05）.The FEV1/FVC and FEV1%in case 1 and case 2 groups were lower than those in control group（P〈0.05）,but the lung function of case 2 group decreased more obviously.There were negative correlations between plasma periostin and FEV1/FVC,periostin and FEV1%,bFGF and FEV1/FVC,bFGF and FEV1%,TNF-a and FEV1/FVC,TNF-a and FEV1%,IL-6 and FEV1/FVC,IL-6 and FEV1%,IL-8 and FEV1/FVC,IL-8 and FEV1%.Conclusion Periostin,bFGF,TNF-a,IL-6 and IL-8 play important roles in the formation and progression of emphysema.The lung function of emphysematous AECOPD patients is worse than that of bronchitis AECOPD patients.