MCP-1、IL-17、IL-35与慢性阻塞性肺病急性加重期患者肺功能的相关性

The Correlation Between MCP-1,IL-17,IL-35 and Lung Function in Patients with Acute Exacerbation of COPD

目的探讨血清单核细胞趋化蛋白-1(MCP-1)、白介素-17(IL-17)、白介素-35(IL-35)与慢性阻塞性肺病急性加重期(AECOPD)患者肺功能的相关性。方法选取2017年6月至2019年12月期间我院呼吸科收治的104例AECOPD患者作为研究对象,设为加重组。选取同期收治的COPD稳定期患者50例作为稳定组,选取同期进行体检的健康人50例作为对照组。比较各组间血清MCP-1、IL-17、IL-35水平及肺功能指标,并进行Pearson相关性分析和Logistic多元回归分析。结果相比于对照组,稳定组和加重组WBC、CRP、PCT、中性粒细胞、嗜酸性粒细胞升高(P<0.05);相比于稳定组,加重组WBC、CRP、PCT、中性粒细胞、嗜酸性粒细胞升高(P<0.05)。相比于对照组,稳定组和加重组MCP-1、IL-17升高,IL-35、FEV1/FVC%、FEV1%pred降低(P<0.05);相比于稳定组,加重组MCP-1、IL-17升高,IL-35、FEV1/FVC%、FEV1%pred降低(P<0.05)。加重组患者治疗后MCP-1、IL-17显著低于治疗前,IL-35、FEV1/FVC%、FEV1%pred显著高于治疗前(P<0.05)。随着AECOPD患者GOLD分级的增加,MCP-1、IL-17不断升高,IL-35、FEV1/FVC%、FEV1%pred不断降低(P<0.05)。经过Pearson相关性分析,MCP-1、IL-17与AECOPD患者肺功能指标(FEV1/FVC%、FEV1%pred)均呈负相关(P<0.05),IL-35与肺功能指标(FEV1/FVC%、FEV1%pred)均呈正相关(P<0.05)。经过Logistic多元回归分析,MCP-1、IL-17是AECOPD患者GOLD分级的危险因素,IL-35是其保护因素。结论血清MCP-1、IL-17、IL-35水平与AECOPD患者肺功能严重程度有关。

Objective To investigate the correlation between serum monocyte chemotactic protein-1(MCP-1),interleukin-17(IL-17),and interleukin-35(IL-35)and lung function of patients with acute exacerbation of chronic obstructive pulmonary disease(COPD).Methods 104 patients with AECOPD treated in the respiratory department of our hospital from June,2017 to December,2019 were selected as the research objects and set as the aggravated group.In the same period,50 patients with stable stage of COPD were selected as the stable group,and 50 healthy people from physical examination were selected as the control group.Serum MCP-1,IL-17,and IL-35 levels and lung function indexes were compared among these groups,and Pearson correlation analysis and logistic multivariate regression analysis were performed.Results Compared with the control group,the recombinant WBC,CRP,PCT,neutrophils and eosinophils were higher in the stable group and aggravated group(P<0.05).Compared with the stable group,the recombinant WBC,CRP,PCT,neutral Granulocytes and eosinophils were higher in the aggravated group(P<0.05).Compared to the control group,the stable group and the aggravated group had higher levels of MCP-1 and IL-17,while IL-35,FEV1/FVC%,and FEV1%pred were lower(P<0.05).Compared to the stable group,the aggravated group had higher levels of MCP-1 and IL-17,but IL-35,FEV1/FVC%,FEV1%pred were lower(P<0.05).Also in the aggravated group,MCP-1 and IL-17 were significantly lower after treatment with recombination patients than before treatment,while IL-35,FEV1/FVC%,FEV1%pred were significantly higher than before treatment(P<0.05).With the increase of GOLD grade in AECOPD patients,MCP-1 and IL-17 were continuously increased,while IL-35,FEV1/FVC%,and FEV1%pred were continuously decreased(P<0.05).Pearson correlation analysis showed that MCP-1 and IL-17 were positively correlated with pulmonary function index(FEV1/FVC%,FEV1%pred)in patients with AECOPD(P<0.05),while IL-35 was negatively correlated with pulmonary function index(FEV1/FVC%,FEV1%pred)(P<0.05).Logistic multivariate regression analysis showed that MCP-1 and IL-17 were risk factors for gold grading in patients with AECOPD,while IL-35 was the protective factor.Conclusion The levels of serum MCP-1,IL-17 and IL-35 are related to the severity of lung function in patients with AECOPD.