慢性阻塞性肺疾病急性加重期患者血清高迁移率族蛋白B1与炎症因子水平变化及其临床意义

Changes and clinical significance of serum high mobility group protein B1 and inflammatory cytokines in patients with acute exacerbation of chronic obstructive pulmonary disease

目的探讨慢性阻塞性肺疾病(COPD)急性加重期患者血清高迁移率族蛋白B1与炎症因子水平变化及其临床意义。方法选取2018年2月—2020年2月齐齐哈尔医学院附属第一医院收治的200例COPD患者作为研究对象,依据病情特点分为COPD稳定期组(90例)和COPD急性加重期组(110例),同时选取同期健康体检者100例作为对照组。观察三组的第一秒用力呼气容积/用力肺活量(FEV1/FVC)、FEV1占预计值百分比(FEV1%)、血清高迁移率族蛋白B1(HMGB1)、C-反应蛋白(CRP)、白细胞介素-6(IL-6)和白细胞介素-18(IL-18)水平,分析COPD急性加重期患者FEV1/FVC、FEV1%和HMGB1、CRP、IL-6和IL-18的相关性。结果COPD急性加重期组的FEV1/FVC、FEV1%均低于对照组和COPD稳定期组,HMGB1、CRP、IL-6和IL-18均高于对照组和COPD稳定期组;COPD稳定期组FEV1/FVC、FEV1%均低于对照组,HMGB1、CRP、IL-6和IL-18均高于对照组,差异有统计学意义(P<0.05)。COPD急性加重期患者FEV1/FVC、FEV1%与HMGB1、CRP均呈负相关,与IL-6、IL-18呈正相关(P<0.05)。结论HMGB1、CRP、IL-6和IL-18水平在COPD患者中异常变化,且与患者肺功能有一定相关性。

Objective To investigate the changes and clinical significance of serum high mobility group protein B1 and inflammatory cytokines in patients with acute exacerbation of chronic obstructive pulmonary disease(COPD).Methods A total of 200 COPD patients admitted to The First Affiliated Hospital of Qiqihar Medical University from February 2018 to February 2020 were selected as the research objects,and were divided into COPD stable stage group(90 cases)and COPD acute exacerbation group(110 cases)according to their disease characteristics.At the same time,100 healthy subjects were selected as the control group.The forced expiratory volume in the first second/forced vital capacity(FEV1/FVC),the percentage of FEV1 in the predicted value(FEV1%),the serum levels of high mobility group protein B1(HMGB1),C-reactive protein(CRP),interleukin-6(IL-6)and interleukin-18(IL-18)in three groups were observed.The correlation between FEV1/FVC,FEV1%and HMGB1,CRP,IL-6 and IL-18 in patients with acute exacerbation of COPD was analyzed.Results The FEV1/FVC and FEV1%in COPD acute exacerbation group were lower than those in the control group and COPD stable stage group,and the HMGB1,CRP,IL-6 and IL-18 were higher than those in the control group and COPD stable stage group,FEV1/FVC and FEV1%in COPD stable stage group were lower than those in control group,and HMGB1,CRP,IL-6 and IL-18 were higher than those in control group,the differences were statistically significant(P<0.05).In patients with acute exacerbation of COPD,FEV1/FVC and FEV1%were negatively correlated with HMGB1 and CRP,while positively correlated with IL-6 and IL-18(P<0.05).Conclusion The levels of HMGB1,CRP,IL-6 and IL-18 are abnormally changed in COPD patients,which are related to the lung function of the patients.