呼出气NO及IL-32在慢性阻塞性肺疾病中的改变及意义探讨

Changes and significance of exhaled NO and IL-32 in COPD

目的探讨FeNO及血清IL-32水平在慢阻肺中的改变和意义。方法收集确诊慢阻肺患者87例,其中AECOPD组46例,慢阻肺稳定期组41例并按严重程度分为Ⅰ、Ⅱ、Ⅲ、Ⅳ级;随机选择同期健康成年人93例作为对照组。检测血清IL-32、FeNO和FEV_1/FVC、FEV_1%水平并分析其相关性。结果血清IL-32、FeNO总体水平均呈现AECOPD组高于慢阻肺稳定期组高于健康对照组(P<0.01)。AECOPD组治疗后总体患者血清IL-32、FeNO水平较治疗前降低显著(P<0.01;P<0.05)。Ⅰ、Ⅱ、Ⅲ、Ⅳ级各级之间血清IL-32、FeNO水平随着级数增加,血清IL-32浓度渐高(P<0.01),而FeNO水平渐低(P<0.05)。血清IL-32与FEV_1/FVC、FEV_1%在AECOPD治疗前(r=-0.651,-0.621,P<0.01)、后(r=-0.711,-0.745,P<0.01)及慢阻肺稳定期(r=-0.594,-0.618,P<0.01)均呈现显著负相关。FeNO在AECOPD治疗前与FEV_1/FVC呈现正相关(r=0.323,P=0.033)。结论血清IL-32在一定程度上与慢阻肺气流受限的严重程度有关,血清IL-32和FeNO均与AECOPD炎症加重有关,二者在慢阻肺的诊疗上具有一定的指示作用。

Objective To investigate the changes and significance of FeNO and serum IL-32 levels in COPD.Methods 87 COPD patients were collected,including 46 AECOPD cases and 41 stable COPD cases.According to severity status,they were divided into I,II,III,IV grades respectively.93 healthy adults were randomly enrolled as the control group.Serum IL-32,FeNO,FEV 1/FVC and FEV 1%were detected in each group,and then correlation analysis would be conducted.Results In total,the levels of serum IL-32 and FeNO in the AECOPD group were higher than those in the COPD group(P<0.01).For AECOPD patients,serum IL-32 and FeNO were significant lower after certain appropriate treatment compared with that of before treatment(P<0.01;P<0.05).Besides,as lung function deteriorated,the numerical values of serum IL-32 were gradually increased,but FeNO gradually decreased(P<0.01;P<0.05).There were significant negative correlations between serum IL-32 and FEV 1/FVC,FEV 1%compared with before treatment(r=-0.651,-0.621,P<0.01),after treatment(r=-0.711,-0.745,P<0.01)and stable stage(r=-0.594,-0.618,P<0.01).FeNO was positively correlated with FEV 1/FVC(r=0.323,P=0.033),but there was no significant correlation with FEV 1%(r=0.195,P=0.204)before treatment.There was no correlation between FeNO and FEV 1/FVC,FEV 1%(r=0.248,0.244,P=0.105;P=0.109)after treatment,as well as in stable COPD stage(r=-0.238,-0.289,P=0.139,0.07).Conclusion Serum IL-32 is related to the severity of COPD airflow.Serum IL-32 and FeNO are associated with the aggravation of AECOPD inflammation,both of which have a certain indication in the diagnosis and treatment of COPD.