哮喘-慢阻肺重叠患者呼出气冷凝液中8-异前列腺素和白三烯B4与肺功能的关系分析

Analysis of the relationship of 8-isoprostaglandin and leukotriene B4 in exhaled air condensate with pulmonary function in patients with asthma-chronic obstructive pulmonary disease overlap syndrome

目的对健康非吸烟志愿者、健康吸烟志愿者和哮喘-慢阻肺重叠综合征(ACOS)患者的呼出气冷凝液(EBC)细胞因子进行测量,并分析细胞因子与ACOS患者肺功能的关系。方法选择2017年10月至2019年10月在本院治疗的74例ACOS患者作为研究对象,其中40例ACOS稳定期患者和34例ACOS急性加重期患者。同时,选择同期肺功能正常健康体检者45例作为对照,包括24例非吸烟者和21例吸烟者。采用多重微珠流式荧光免疫法分析呼气冷凝液中8-异前列腺素(8-iso-PG)、肿瘤坏死因子α(TNF-α)、白三烯B4(LTB4)和白介素-6(IL-6)细胞因子浓度。应用Pearson分析ACOS患者EBC细胞因子与肺功能指标的关系。结果与对照组相比,ACOS稳定期组和ACOS急性加重期组患者的FEV1、FVC、FEV1/FVC和PaO2均显著降低(P<0.05),并且EBC中的8-iso-PG、LTB4、IL-6和TNF-α水平均显著升高(P<0.05)。其中,ACOS急性加重期组患者EBC中的8-iso-PG、LTB4、IL-6和TNF-α水平的升高程度显著高于ACOS稳定期组(P<0.05)。Pearson分析显示,细胞因子8-iso-PG、LTB4、TNF-α水平与FEV1、FVC、FEV1/FVC肺功能指标显著相关(P<0.05)。结论 EBC中的8-iso-PG、LTB4在ACOS患者中明显增加,尤其是急性加重期患者,并且与患者的肺功能降低密切相关。

Objective To characterize the exhaled breath condensate(EBC)cytokine pattern of inflammation in healthy non-smoking volunteers,healthy smoking volunteers,and patients with asthma-chronic obstructive pulmonary overlap syndrome(ACOS),and to analyze the relationship between cytokines and lung function in patients with ACOS.Methods From October 2017 to October 2019,74 patients with ACOS who were treated in our hospital were selected as the study objects,including 40 patients with stable ACOS and 34 patients with acute exacerbated ACOS.At the same time,45 healthy people with normal lung function were selected as the control group,including 24 non-smokers and 21 smokers.The concentrations of 8-isoprostaglandin(8-iso-PG),tumor killing factorα(TNF-α),leukotriene B4(LTB4)and interleukin-6(IL-6)in EBC were determined by multiple bead flow cytometry.Pearson was used to analyze the relationship between EBC cytokines and lung function in patients with ACOS.Results Compared with the control group,the level of FEV1,FVC,FEV1/FVC and PaO2 were significantly lower in the stable ACOS group and the acute exacerbated ACOS group(P<0.05),and the concentrations of 8-iso-PG,LTB4,IL-6 and TNF-αwere significantly higher(P<0.05).Among them,the concentrations of 8-iso-PG,LTB4,IL-6 and TNF-αin the acute exacerbated ACOS group were significantly higher than in the stable ACOS group(P<0.05).Pearson analysis showed that the concentrations of cytokines 8-iso-PG,LTB4,and TNF-αwere significantly correlated with lung function indicators of FEV1,FVC,FEV1/FVC(P<0.05).Conclusion The concentrations of 8-iso-PG and LTB4 increase in patients with ACOS,especially in patients with acute exacerbated ACOS,and they are closely related to the reduction of lung function.