慢性阻塞性肺疾病患者呼吸道合胞病毒感染后血清TH2类细胞因子及肺表面活性蛋白D水平的研究

Study on serum levels of TH2 cytokines and SP-D level in COPD patients after respiratory syncytial virus infection

目的了解稳定期慢性阻塞性肺疾病(COPD)患者呼吸道合胞病毒(RSV)感染情况、血清TH2类细胞因子和SP-D水平,探讨RSV感染情况及对COPD患者病情的影响。方法选取稳定期COPD患者144例,检测RSV,记录肺功能,检测血清IL-4、IL-10及SP-D,分析患者肺功能和血清分子水平与RSV感染的关系,以及各分子与患者病情的关系。结果 RSV阳性的COPD患者有45例(31.25%)。RSV阳性组患者的肺功能均低于RSV阴性组,差异均有统计学意义(P<0.05)。RSV阳性组患者的血清IL-4、1L-10和SP-D水平明显高于RSV阴性组,差异有统计学意义(P<0.05)。随着患者COPD分级的提高,血清L-4、1L-10、SP-D水平逐渐升高,以Ⅲ级、Ⅳ级组更为明显(P<0.05)。结论 COPD稳定期患者存在一定的RSV感染率。患者血清IL-4、IL-10和SP-D的表达增加与RSV感染情况和患者病情进展相关,检测相关细胞因子水平对了解患者病情和指导治疗具有重要参考价值。

Objective To understand the status of respiratory syncytial virus(RSV)infection in patients with chronic obstructive pulmonary disease(COPD)during stable period,assess the serum levels of TH2 cytokines and SP-D,and investigate the clinical features of RSV infection and its effect on the progression of patients with COPD.Methods A total of 144 patients with stable COPD were selected as study subjects.RSV was detected and lung function was recorded.Serum levels of IL-4,IL-10,and SP-D were measured.The relationship of lung function,serum IL-4,IL-10,SP-D levels with RSV infection were analyzed.Relationship of IL-4,IL-10,and SP-D levels with disease status of COPD patients was also analyzed.Results A total of 45 COPD patients(31.25%)with RSV positive were observed.RSV positive group had lower lung function than RSV negative group,and the difference was statistically significant(P<0.05).Serum levels of IL-4,1 L-10,and SP-D in RSV-positive patients were significantly higher than those in RSV-negative patients,with the differences statistically significant(P<0.05).With the increase of COPD classification,the levels of serum L-4,1 L-10,and SP-D increased gradually,especially grade III and IV(P<0.05).Conclusion There is a certain rate of RSV infection in patients with stable COPD.In addition,the increase of serum IL-4,IL-10,and SP-D levels is associated with RSV infection and progression of patient′s condition.Detection of related cytokines has important reference value for understanding patient′s condition and guiding treatment.