COPD患者血清sCD40L TNF-α及MMP-9水平及意义

Serum Levels and Significance of SCD40L TNF-αand MMP-9 in Patients with COPD

目的:观察慢性阻塞性肺病(chronic obstructive pulmonary disease,COPD)患者血清可溶性CD40配体(Soluble Cluster of differentiation 40 ligand,sCD40L)、肿瘤坏死因子α(tumor necrosis factor-α,TNF-α)及基质金属蛋白酶9(matrix metalloproteinase-9,MMP-9)的表达水平,并分析其检测意义。方法:选取本院82例COPD患者,按照临床分期分为急性加重期组(n=46)与临床缓解期组(n=36),并取同期40例体检健康者为对照组,比较三组血清sCD40L、TNF-α、MMP-9表达水平与肺功能指标[1s用力呼气容积(FEV1)、用力肺活量(FVC)、FEV1/FVC、FEV1占预计值百分比(FEV1%)],并进行相关性分析。结果:急性加重期组血清sCD40L、TNF-α、MMP-9表达水平明显高于临床缓解期组与对照组(P<0.017),且临床缓解期组显著高于对照组(P<0.017);急性加重期组FEV1、FVC、FEV1/FVC、FEV1%显著低于临床缓解期组与对照组(P<0.017),临床缓解期组明显低于对照组(P<0.017);COPD患者血清sCD40L、TNF-α、MMP-9水平与肺功能(FEV1/FVC、FEV1%)呈负相关(P<0.05)。结论:COPD患者存在血清sCD40L、TNF-α、MMP-9表达水平升高趋势,特别是急性加重期患者升高更为显著,sCD40L、TNF-α、MMP-9水平越高,患者肺功能越差,其检测可为COPD病情评估提供有效依据。

Objective:To observe the expression levels of serum soluble CD40 ligand(sCD40L),tumor necrosis factorα(TNF-α)and matrix metalloproteinase 9(MMP-9)in patients with chronic obstructive pulmonary disease(COPD)and analyze their significance.Methods:82 patients with COPD were selected and divided into acute exacerbation group(n=46)and clinical remission group(n=36)according to the clinical staging.Meanwhile,40 healthy people were made the control group.The expression levels of serum sCD40L,TNF-αand MMP-9 and lung function indexes[forced expiratory volume in 1s(FEV1),forced vital capacity(FVC),FEV1/FVC,the percentage of FEV1 in predicted value(FEV1%)]were compared among the 3 groups,and correlation analysis was performed.Results:The order of expression levels of serum sCD40L,TNF-αand MMP-9 in the 3 groups from high to low was as follows:the acute exacerbation group,the clinical remission group,the control group(P<0.017).The order of FEV1,FVC,FEV1/FVC and FEV1%in the 3 groups from low to high was as follows:the acute exacerbation group,the clinical remission group,the control group(P<0.017).Serum sCD40L,TNF-αand MMP-9 levels were negatively correlated with lung function(FEV1/FVC,FEV1%)in patients with COPD(P<0.05).Conclusion:The expression levels of serum sCD40L,TNF-αand MMP-9 in patients with COPD show an increasing trend,especially in patients with acute exacerbation.The higher the sCD40L,TNF-αand MMP-9 levels,the worse the lung function.The detection of the three indexes can provide an effective basis for the evaluation of COPD.