支气管哮喘和慢性阻塞性肺病患者血清ICAM-1、IL-8水平的变化及吸入皮质激素作用的对比研究

The change of ICAM-1、IL-8 in the serum from patients with COPD or asthma and the effects of inhaled corticosticoid

目的探讨细胞间粘附分子 1 (ICAM 1 )、白细胞介素 8(IL 8)在支气管哮喘 (哮喘 )、慢性阻塞性肺病 (COPD)发病机制中的作用和吸入皮质激素对哮喘、COPD患者的影响。方法 6 0例COPD急性发作期患者随机分为一般治疗组 30例 (COPDⅠ组 )和加用吸入激素组 30例 (COPDⅡ组 ) ,哮喘急性发作期 1 5例及健康对照组 30例。各病例组分别于入院时及治疗 2周后取静脉血 4ml,同时测峰值呼气流速 (PEF)。IL 8采用放免法、ICAM 1采用ELLISA法测定。结果 3组治疗前后ICAM 1、IL 8水平均显著高于对照组 (P <0 0 1或P <0 0 5 ) ,其PEF显著低于对照组 (P <0 0 1 ) ,治疗后ICAM 1、IL 8水平显著低于急性发作期 (P <0 0 1或P <0 0 5 ) ,其PEF有明显改善 (P <0 0 1 ) ;哮喘治疗前后ICAM 1、IL 8水平显著低于COPDⅠ、Ⅱ组治疗前后 (P <0 0 1或P <0 0 5 ) ,其PEF显著高于COPDⅠ、Ⅱ组 (P <0 0 1 ) ;COPDⅠ组治疗前后与COPDⅡ组治疗前后比较ICAM 1、IL 8水平差异无显著性 (P >0 0 5 ) ,但COPDⅡ组治疗后PEF改善显著优于COPDⅠ组 (P <0 0 1 )。结论ICAM 1、IL 8在哮喘、慢性阻塞性肺病气道炎症的形成中起着重要作用 ,哮喘急性发作期短期吸入皮质激素可抑制ICAM 1、IL 8表达 ,而在COPD急性发作期患者短期吸入皮质激素并?

objective To evaluate the role of ICAM 1、IL 8 in the pathogenesis of COPD and asthma,and determine whether patients with COPD or ashma have favorable response to inhaled corticosticoid. Methods A randomized,placebo controlled trial of inhaled beclomethasone was carried out in 60 patients with acute COPD.The serum samples were obtained from 60 patients with acute COPD ,15 patients with acute asthma and 30 normal control before and after two weeks therapy,and the PEF were mersured at the same time.ICAM 1 level were measured by ELLISA,IL 8 level measurd by RIA.Results The serum ICAM 1、IL 8 level in the three groups before and after therapying were significantly higher than control group( P <0 01 or P <0 05),their PEF were significantly lower than control group( P <0 01).After therapying their ICAM 1、IL 8 level were significantly lower than attack stage( P <0 01 or P <0 05),their PEF were significantly higher than attack stage ( P <0 01).The ICAM 1、IL 8 level of asthma were significantly lower than COPD Ⅰ and COPD Ⅱ group before and after therapying ( P <0 01 or P <0 05),the PEF were significantly higherer than COPD Ⅰ and COPD Ⅱ group ( P <0 01).The ICAM 1、IL 8 level in COPD Ⅰ and Ⅱ group were not significant before and after therapying ( P >0 05),but after therapying the PEF of COPD Ⅱ group were significantly higher than COPD Ⅰ group ( P <0 01).Conclusion ICAM 1、IL 8 play an impotant role in the pathogenitic process of COPD and asthma.Inhald coscoriccoid two weeks can inhibit the espression of ICAM 1、IL 8 in asthma,but can′t downregulate ICAM 1、IL 8 in acute COPD.Inhaled coscorticoid for two weeks can be helpful to the lung function.