痰液中IL-8、IL-17、SIgA水平与慢阻肺稳定期患者肺功能的相关性研究

Study on correlation between IL-8,IL-17,SIgA levels in sputum and pulmonary function in patients with stable stage of chronic obstructive pulmonary disease

目的分析慢性阻塞性肺疾病(COPD)稳定期患者痰液中白细胞介素(IL)-8(IL-8)、IL-17、分泌型免疫球蛋白A(SIgA)水平与肺功能损伤加重的相关性。方法选取2019年1月-2020年12月新疆医科大学第二附属医院门诊63例COPD稳定期患者,全部患者均接受为期1年的随访,跟据随访结束时患者肺功能损伤程度分为轻度损伤组与中、重度损伤组,调查两组患者一般资料、检测实验室指标并比较,分析痰液中IL-8、IL-17、SIgA水平患者肺功能损伤的关系。结果63例COPD稳定期患者,肺功能中、重度损伤15例,轻度损伤48例;与轻度损伤组比较,中、高度损伤组患者血清高迁移率族蛋白BI(HMGBI)、缺氧诱导因子-1α(HIF-1α)水平较高;痰液中IL-8、IL-17水平较高,SIgA水平较低,差异有统计学意义(P<0.05).相关性分析结果显示,COPD稳定期患者痰液中IL-8与IL-17之间呈正相关(r>0,P<0.05),IL-8、IL-17分别与SIgA间呈负相关(r<0,P<0.05)。二元Logistic回归分析后建立多元回归模型结果显示,血清HMGBI、HIF-1α过表达,痰液中IL-8、IL-17过表达及SIgA低表达是患者肺功能损伤加重的影响因素(OR>1,P<0.05)。ROC曲线分析显示,痰液中IL-8、IL-17、SIgA水平单独及联合预测COPD稳定期患者肺功能损伤加重的AUC均>0.80。结论COPD稳定期患者肺功能损伤加重与痰液中IL-8、IL-17过表达及SIgA低表达有关,临床上可以通过检测患者痰液中IL-8、IL-17、SIgA表达,预测肺功能损伤加重的风险。

Objective To analyze the correlation between interleukin(IL)-8,IL-17,secretory immunoglobulin A(SIgA)in the sputum and the aggravation of pulmonary function injury in patients with stable stage of chronic obstructive pul⁃monary disease(COPD).Methods 63 patients with stable stage of COPD admitted to the Department of Outpatient,the Second Affiliated Hospital of Xinjiang Medical University from January 2017 to December 2018 were selected.All pa⁃tients received a 1-year follow-up.According to the degree of lung function damage at the end of the follow-up,they were divided into a mild injury group,and a moderate and severe injury group.The general information,testing labora⁃tory indicators of the two groups were investigated and compared,the relationship between lung function damage and IL-8,IL-17 and SIgA levels in sputum were analyzed.Results Among all 63 patients suffered from the stable stage of COPD,15 had moderate or severe lung function impairment,and 48 had mild impairment.Compared with the mild in⁃jury group,the levels of high mobility group protein BI(HMGBI)and hypoxia inducible factor-1α(HIF-1α)in serum were higher in the medium and high injury group;so do the levels of IL-8 and IL-17 in sputum;while the level of SI⁃gA was lower,with statistical significant differences(P<0.05).Correlation analysis showed that there was a positive cor⁃relation between IL-8 and IL-17 in the sputum of patients with stable stage of COPD(r>0,P<0.05);IL-8 and IL-17 were negatively correlated with SIgA(r<0,P<0.05).A multiple regression model was established after binary logistic regression analysis,and the results showed that the overexpression of HMGBI and HIF-1αin serum,as well as the overexpression of IL-8,IL-17 and the low expression of SIgA in sputum were the influencing factors for the aggrava⁃tion of lung function damage(OR>1,P<0.05).The analysis of receiver operating characteristic(ROC)curve showed that the levels of IL-8,IL-17,and SIgA in sputum predicted the area under curve(AUC)of deteriorating lung function damage in patients were>0.80 both separately and jointly.Conclusion The aggravation of lung function damage in pa⁃tients with stable stage of COPD may be related to the overexpression of IL-8 and IL-17 and the low expression of SI⁃gA in sputum.Clinically,the risk of exacerbation of lung function injury can be predicted by detecting the expression of IL-8,IL-17 and sIgA in sputum of patients.