慢性阻塞性肺疾病急性发作患者呼出气冷凝液炎症因子检测对预后的评估价值

Value of the detection of inflammatory factors in exhaled breath condensate of the patients with acute attacks of chronic obstructive pulmonary disease for the prognostic assessment

目的探讨慢性阻塞性肺疾病急性发作患者呼出气冷凝液炎症因子检测对患者预后的指导价值。方法选择2018年7月至2019年10月本院收治的慢性阻塞性肺疾病急性发作患者40例,搜集所有患者的冷凝液,比较治疗前后机体氧代谢指标及肺功能指标,统计治疗前后炎症相关因子水平,及治疗前、治疗后3 d、7 d炎症因子变化趋势,并分析超敏-C反应蛋白(hs-CRP)水平与氧摄取率及第1秒用力肺活量(FEV1)的相关性。结果治疗后机体氧摄取率高于治疗前(P<0.05),动脉血氧含量高于治疗前(P<0.05),治疗后FEV1高于治疗前(P<0.05),1 s用力呼气容积/用力肺活量(FEV1/FVC)水平大于治疗前(P<0.05),治疗后hs-CRP及白细胞介素-1(IL-1)、肿瘤坏死因子-α(TNF-α)水平均显著低于治疗前(P<0.05),随着时间的推移,患者炎症因子hs-CRP水平、IL-1水平及TNF-α水平均呈下降趋势(P<0.05),hs-CRP水平与氧摄取率及FEV1值呈负相关。结论慢性阻塞性肺疾病急性发作者行呼出气冷凝液检测,可通过冷凝液中炎症因子水平变化对患者预后进行预测。

Objective To explore the guiding value of the detection of inflammatory factors in exhaled breath condensate(EBC)of the patients with acute attacks of chronic obstructive pulmonary disease(COPD)for the prognosis of the patients.Methods A total of 40 patients with acute attacks of COPD admitted to and treated in our hospital from July 2018 to October 2019 were selected.EBC of each of the selected patients was collected;the indexes of oxygen metabolism of the whole body and pulmonary function parameters before and after treatment were compared;the levels of inflammation-related factors before and after treatment and the changing trend of inflammatory factors before,3 d and 7 d after treatment were counted;the correlation between the level of high sensitivity C-reactive protein(hs-CRP)and the extraction rate of oxygen(ERO2)and that between the level of hs-CRP and the forced expiratory volume in the first second(FEV1)were analyzed.Results After treatment,the ERO2 of the whole body was higher than that before treatment(P<0.05),and the oxygen content of arterial blood(CaO2)was higher than that before treatment(P<0.05).After treatment,the FEV1 level was higher than that before treatment(P<0.05),and the level of the forced expiratory volume in the first second/forced vital capacity(FEV1/FVC)was higher than that before treatment(P<0.05).After treatment,the levels of hs-CRP,interleukin-1(IL-1),tumor necrosis factor-α(TNF-α)were all significantly lower than those before treatment(P<0.05).With time,the levels of hs-CRP,IL-1 and TNF-αof inflammatory factors in the patients showed a downward trend(P<0.05).The level of hs-CRP was negatively correlated with ERO2 and the FEV1 value.Conclusion The detection of the changes in the levels of inflammatory factors in the EBC of the patients with acute attacks of COPD can help to predict the prognosis of the patients.