AECOPD患者血清IL-6,TNF-α,G-CSF,CRP,PCT水平及其与病情严重程度的相关性分析

Correlation of serum IL-6,TNF-α,G-CSF,CRP and PCT levels with the severity of patients with AECOPD

目的研究慢性阻塞性肺疾病急性加重期(AECOPD)患者的血清白介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)、粒细胞集落刺激因子(G-CSF)、C反应蛋白(CRP)及血清降钙素原(PCT)水平变化及与病情程度相关性。方法研究对象选取我院2015年3月到2016年10月间收治的AECOPD患者217例,根据患者有无呼吸衰竭将其分为呼吸衰竭组(87例)和非呼吸衰竭组(130例),同期选择100例体检的健康者作为对照组。分别检测所有研究对象的血清炎症因子水平、肺功能指标、血气指标及圣乔治呼吸问卷(SGRQ)评分,并比较其在各组研究对象中的差异,同时Pearson相关性分析炎症因子与病情指标相关性。结果呼吸衰竭组的血清IL-6、TNF-α、CRP、PCT及G-CSF水平均明显高于非呼吸衰竭组(P<0.01),AECOPD患者的血清IL-6、TNF-α、CRP、PCT及G-CSF水平均明显高于对照组(P<0.01),呼吸衰竭组的FEV_1%、FEV_1/FVC、Pa O_2均明显低于非呼吸衰竭组(P<0.01),SGRQ评分明显高于对照组(P<0.01);Pearson相关性分析显示,血清炎症因子水平与FEV_1%、FEV_1/FVC、Pa O_2均呈明显负相关(P<0.01),与SGRQ评分均呈明显正相关(P<0.01)。结论 AECOPD患者血清各炎症因子水平均明显升高,且与患者病情程度呈正相关,对患者病情监测及治疗指导有着重要作用,值得在临床推广。

Objective To study the correlation of serum IL-6,TNF-α,G-CSF,CRP and PCT levels with the severity of patients with AECOPD.Methods A total of 217 AECOPD patients were admitted in our hospital from March 2015 to October 2016,and they were divided into the respiratory failure group(87 cases)and the non respiratory failure group(130 cases)according to whether the patients had respiratory failure,and 100 healthy cases were taken as the control group.Their serum levels of inflammatory factors,pulmonary function,blood gas index and St Georges Respiratory Questionnaire(SGRQ)score were detected and compared,and Pearson correlation correlation analysis was used to analyze the relationship between inflammatory factors and disease severity.Results The levels of serum IL-6,TNF-α,CRP,PCT,and G-CSF were significantly higher in the respiratory failure group than in the non respiratory failure group(P<0.01),and they were obviously higher in the AECOPD group than in the control group(P<0.01).The value of FEV 1%,FEV 1/FVC and PaO 2 were significantly lower in the respiratory failure group than in the non respiratory failure group(P<0.01),and SGRQ score was significantly higher in the AECOPD group than in the control group(P<0.01).Pearson correlation analysis showed that serum levels of inflammatory factors and FEV 1%,FEV 1/FVC and PaO 2 were negatively correlated(P<0.01),and SGRQ scores were positively correlated(P<0.01).Conclusion The level of serum inflammatory factors increases significantly in AECOPD patients,and it is positively related with the severity of disease,which has important guidance on monitoring and treatment and worthy of widely clinical application.