夜间低氧对慢性阻塞性肺疾病患者血清IL-6、IL-8的影响

Effects of nocturnal hypoxia on serum IL-6 and IL-8 in patients with chronic obstructive pulmonary disease

目的:探讨慢性阻塞性肺疾病(COPD)患者夜间低氧与全身炎症反应的关系。方法:选择中度至极重度COPD患者70例,年龄45~74岁,平均(65.41±7.84)岁。按多导睡眠监测结果将研究对象分为低氧组和非低氧组,均行肺功能和多导睡眠监测、炎症指标检测。比较各组血清IL-6及IL-8的差异,分析炎症指标与睡眠呼吸参数的相关性。结果:睡眠低氧组27例,低氧率为38.57%,低氧组血清IL-6、IL-8分别为(14.34±2.76)ng/mL、(68.49±9.65)ng/mL,明显高于非低氧组的(11.79±1.85)ng/mL、(61.62±8.47)ng/mL(均P<0.001)。经校正年龄、体质量指数后,IL-6与睡眠呼吸相关参数TS88正相关(r=0.651,P=0.041),与最低SaO2和平均SaO2负相关(r=-0.644,P=0.038和r=-0.780,P=0.018);IL-8与睡眠呼吸相关参数TS88正相关(r=0.627,P=0.039),与最低SaO2和平均SaO2负相关(r=-0.659,P=0.026和r=-0.732,P=0.014)。结论:中度至极重度COPD患者夜间低氧普遍存在,低氧组患者全身炎症反应明显增强,全身炎症反应与夜间低氧相关。

Objective:To investigate the association between nocturnal hypoxia and systemic inflammatory response in patients with chronic obstructive pulmonary disease.Methods:Seventy moderate to very severe stable COPD patients with an age range of 45-74 years(Average age,[65.41±7.84]years)were included.Patients were divided into nocturnal hypoxia group and non-nocturnal hypoxia group,and lung function,PSG,and inflammatory indicators were performed.The differences of serum IL-6 and IL-8 in each group were compared,the correlation between IL-6 and IL-8 as well as PSG parameters were further evaluated using partial correlation analysis.Results:Twenty-seven patients(38.57%)with nocturnal hypoxia were enrolled.Compared with patients without nocturnal hypoxia,serum IL-6 and IL-8 in the hypoxic group([14.34±2.76]ng/mL and[68.49±9.65]ng/mL,respectively)were significantly higher than those in the non-nocturnal hypoxic group([11.79±1.85]ng/mL and[61.62±8.47]ng/mL,respectively;P<0.001).Additionally,after adjustment for BMI and age,serum IL-6 level showed significant positive correlation with TS88(r=0.651,P=0.041),nevertheless,serum IL-6 level showed significant negative correlation with the lowest SaO and the mean SaO(r=-0.644,P=0.038 and r=-0.780,P=0.018);serum IL-8 level showed significant positive correlations with TS88(r=0.627,P=0.039),nevertheless,serum IL-6 level showed significant negative correlation with the lowest SaO and the mean SaO(r=-0.659,P=0.026 and r=-0.732,P=0.014).Conclusions:Nocturnal hypoxia generally exists in patients with moderate to very severe stable COPD.Compared with the non-nocturnal hypoxia group,the nocturnal hypoxia group has enhanced systemic inflammatory response,which might be correlated with nocturnal hypoxia.