慢性阻塞性肺疾病患者呼出气冷凝液IL-17、IL-10、8-iso-PG水平测定及临床意义

Determination and clinical significance of exhaled air condensate IL-17,IL-10,8-iso-pg in patients with chronic obstructive pulmonary disease

目的测定慢性阻塞性肺疾病(COPD)患者呼出气冷凝液(EBC)中白细胞介素-17(IL-17)、白细胞介素-10(IL-10)、8-异前列腺素(8-iso-PG)的水平,与肺功能指标、生活质量结合分析其临床意义。方法采用回顾性研究方法,选择2016年1月至2018年10月宜宾市第二人民医院呼吸科收治的65例COPD患者作为研究对象,作为观察组(n=65),给予常规治疗;另选择同期进行健康体检者作为对照组(n=50)。收集观察组治疗前、治疗后以及对照组的EBC,采用酶联免疫吸附试验(ELISA)测定两组受检者的IL-17、IL-10、8-iso-PG,同时进行肺功能检测和圣乔治呼吸问卷(SGRQ)评分,结合第1秒用力呼气容积(FEV1)、用力肺活量(FVC)、第1秒用力呼气容积占预计值百分比(FEV1%)和SGRQ评分分析IL-17、IL-10、8-iso-PG变化的意义。结果观察组患者治疗后的IL-17、IL-10、8-iso-PG与治疗前比较[(5. 82±0. 90) ng/L vs.(10. 81±1. 52) ng/L、(2. 55±0. 46) ng/L vs.(1. 86±0. 22) ng/L、(9. 76±1. 32) ng/L vs.(12. 57±2. 39) ng/L],差异具有统计学意义(P <0. 05);观察组患者治疗后的FEV1、FVC、FEV1%、SGRQ评分与治疗前比较[(1. 32±0. 56) L vs.(1. 11±0. 37) L、(2. 65±0. 74) L vs.(2. 45±0. 57) L、(49. 59±5. 22)%vs.(44. 79±7. 63)%、(20. 63±13. 69)分vs.(35. 96±14. 52)分],差异具有统计学意义(P <0. 05);观察组IL-17、IL-10、8-iso-PG、FEV1、FVC、FEV1%、SGRQ评分较对照组比较均有显著差异(P <0. 05);观察组患者EBC中的IL-17、IL-10、8-iso-PG与FEV1%无显著相关性(r=0. 162,P> 0. 05;r=0. 112,P> 0. 05;r=0. 062,P> 0. 05)。结论COPD患者EBC中的IL-17、IL-10、8-iso-PG水平可以作为监测患者气道炎症、氧化应激以及评价患者肺功能的参考指标,相较于血清标志物有独特优势,具有一定的应用价值。

Objective To determine the significance of interleukin-17 (IL-17), interleukin-10 (IL-10), and 8-isoprostaglandin (8-iso-pg) in exhaled air condensation (EBC) of patients with chronic obstructive pulmonary disease (COPD), and to analyze its clinical significance in combination with pulmonary function indicators and quality of life. Methods A retrospective study was conducted to select 65 patients with COPD admitted to the Department of Respiratory Medicine of Second People's Hospital of Yibin City during January 2016 to October 2018. Patients in observation group (n=65) were given with conventional treatment and another option was selected. The healthy persons in the same period were listed as control group (n=50);the EBC of patients in observation group before treatment, after treatment and persons in control group were collected, and the levels of IL-17 and IL-10 of these two groups were measured by enzyme-linked immunosorbent assay (ELISA),. levels of IL-10, 8-iso-PG, simultaneously the lung function test and St. George's Respiratory Questionnaire (SGRQ) scores, combined with the first second forced expiratory volume (FEV 1), forced vital capacity (FVC), forced expiratory volume in the first second. percentage of value (FEV 1%) and SGRQ scores were used to analyze the significance of changes in levels of IL-17, IL-10, and 8-iso-PG. Results The levels of IL-17, IL-10, and 8-iso-PG in observation group were compared with those before treatment [(5.82±0.90) ng/L vs.(10.81±1.52) ng/L,(2.55±0.46) ng/L vs.(1.86±0.22) ng/L,(9.76±1.32) ng/L vs.(12.57±2.39) ng/L], and the difference was statistically significant ( P <0.05). Patients in observation group were treated with FEV 1, FVC, FEV 1%, and SGRQ scores were compared with those before treatment [(1.32±0.56) L vs.(1.11±0.37) L,(2.65±0.74) L vs.(2.45±0.57)L,(49.59±5.22)% vs.(44.79±7.63)%,(20.63±13.69) points vs.(35.96±14.52) points], and the difference was statistically significant ( P <0.05). IL-17, IL-10 and 8-iso-PG in EBC of patients with COPD in observation group were not correlated with FEV 1%( r =0.162, P >0.05;r =0.112, P >0.05;r =0.062, P >0.05). Conclusion The levels of IL-17, IL-10 and 8-iso-pg in EBC of COPD patients can be used as reference indices for monitoring airway inflammation, oxidative stress and evaluating lung function of patients, they have unique advantages over serum markers and they have certain application value.