TSP-1、VEGF表达及血浆相关炎症因子与慢性阻塞性肺疾病早期急性肺损伤关系

Study on the relationship between the expression of TSP-1,VEGF,and plasma inflammatory factors and early acute lung injury in COPD

目的分析研究TSP-1、VEGF表达及血浆中Th17相关炎症因子与COPD早期急性肺损伤关系研究。方法随机选取了2016年5月至2018年6月之间山东省平度市呼吸病防治所140例COPD患者的临床资料进行回顾性分析。根据病情分为对照组和观察组,每组各70例。利用流式细胞仪、酶联免疫吸附法(ELISA)对相关指标进行测定,并利用Pearson线性相关分析法和logistic回归分析法进行分析。结果与对照组相比,观察组COPD并发早期ALI患者FEV1、FEV1/FVC水平明显降低(P均<0.05);外周血Th17/Treg比值明显增高(t=4.463,P=0.029);而血浆中TSP-1、VEGF、及相关炎症因子水平均明显高于对照组(P<0.05);Pearson相关性分析显示,TSP-1、VEGF与CD4+Th17细胞比率成正相关(r=0.773,P=0.001;r=0.625,P=0.001);logistic回归分析显示,IL-17是COPD早期急性肺损伤的独立危险因素。结论Th17相关炎症因子释放增多,将会加重气道炎症反应,同时还会引起TSP-1、VEGF的表达异常,导致血管内皮功能障碍,进一步加重患者病情,增加COPD患者出现急性肺损伤的风险。

Objective To analyze the relationship between the expression of TSP-1,VEGF,and Th17-related inflammatory factors and early acute lung injury(ALI)in COPD.Methods The clinical data of 140 randomly selected patients with COPD in Pingdu Respiratory Disease Prevention and Treatment Institute from May 2016 to June 2018 were retrospectively analyzed.According to the condition of the disease,they were divided into control group(n=70)and observation group(n=70).The related indicators were determined by flow cytometry and enzyme-linked immunosorbent assay(ELISA).Statistical analysis of data was carried out by Pearson linear correlation analysis and logistic regression analysis.Results Compared with the control group,the levels of FEV1 and FEV1/FVC in the patients with COPD complicated with early ALI were significantly lower,while the ratio of Th17/Treg in peripheral blood was significantly higher in the observation group.The plasma levels of TSP-1,VEGF and related inflammatory factors were significantly higher in the observation group than those in the control group.Pearson correlation analysis showed that TSP-1 and VEGF were positively correlated with CD4+Th17 cell ratio.Logistic regression analysis showed that IL-17 was an independent risk factor for early acute lung injury in COPD.Conclusion The increased release of Th17-related inflammatory cytokines will aggravate the airway inflammatory response,cause abnormal expression of TSP-1 and VEGF,and lead to vascular endothelial dysfunction,which will further aggravate the condition of patients,and increase the risk of acute lung injury in patients with COPD.