血清细胞因子水平检测在COPD急性加重期和稳定期的临床价值研究

Clinical Value of Serum Cytokine Level Detection in Acute Exacerbation and Stable Phase of COPD

探讨血清中肿瘤坏死因子-α《(TNF-α)、白细胞介素-6(IL-6)、白细胞介素-1β(IL-1β)和T淋巴细胞亚群(CD4^+、CD8^+、CD4^+/CD8^+)的水平变化在慢性阻塞性肺疾病(COPD)急性加重期和稳定期中的临床价值研究。选择2018年1月~2018年12月在德阳市第二人民医院病理科收治的COPD患者75例按照不同发病期分为COPD急性期组(n=41)和COPD缓解期组(n=34)同时选择健康体检中心的健康老年人(体检结果无异常)30例作为对照组。分别行肺功能检测对血清TNF-α、IL-6、IL-1β和CD4^+、CD8^+与肺功能指标(FEV1%、FEV1/FVC%)进行相关性分析。COPD缓解期患者血清中TNF-α、IL-6和IL-1β的水平均较急性期时明显下降,但均比对照组高差异均有统计学意义(P<0.05);COPD缓解期患者血清中CD4^+、CD4^+/CD8^+均较急性期时明显升高,但均比对照组低,差异均有统计学意义(P<0.05);COPD缓解期患者血清中CD8^+较急性期时降低,但仍比对照组高差异有统计学意义(P<0.05)。COPD患者血清TNF-α、IL-6、IL-1β及CD8^+百分比与肺功能指标中的FEV1%、FEV1/FVC%均呈负相关(P<0.05);CD4^+百分比、CD4^+/CD8^+与肺功能指标中的FEV1%、FEV1/FVC%均呈正相关(P<0.05)。结果证明:血清TNF-α、IL-6、IL-1β和CD4^+、CD8^+均参与了COPD的发生发展,并与肺功能相关联,可为判断患者病情严重程度、治疗效果及预后提供一定的依据。

To investigate serum tumor necrosis factor-α(TNF-α),interleukin-6(IL-6),interleukin-1β(IL-1β)and T lymphocyte subsets(CD4^+,CD8^+The clinical value of CD4^+/CD8^+)in acute exacerbation and stable phase of chronic obstructive pulmonary disease(COPD),a total of 75 COPD patients who were treated in the department of pathology of Deyang Second People’s Hospital from January 2018 to December 2018 were selected and divided into the acute COPD group(n=41)and the COPD remission group(n=34),and at the same time,30 healthy elderly people(with no abnormal results)in the health examination center were selected as the control group.Lung function tests were performed,and the correlation analysis of serum TNF-α,IL-6,IL-1αand CD4^+,CD8^+with lung function indicators(FEV1%,FEV1/FVC%)was performed.The serum levels of TNF-α,IL-6 and IL-1αin patients with COPD remission were significantly lower than those in the acute stage,but they were higher than those in the control group,and the differences were statistically significant(P<0.05).The CD4^+and CD4^+/CD8^+levels in serum of patients with stage 2 were significantly higher than those in the acute phase,but they were lower than those in the control group,and the differences were statistically significant(P<0.05),but still higher than the control group,the difference was statistically significant(P<0.05).COPD patients’serum TNF-α,IL-6,IL-1α,and CD8^+percentages were negatively correlated with FEV1%and FEV1/FVC%in lung function indicators(P<0.05).CD4^+percentage,CD4^+/CD8^+,and lung function indicators were positive correlation with FEV1%and FEV1/FVC%(P<0.05).Serum TNF-α,IL-6,IL-1α,CD4^+and CD8^+are involved in the occurrence and development of COPD,and are associated with pulmonary function.It provided a basis for judging the severity of the patient’s condition,treatment effect and prognosis.