血清皮质醇及相关炎症因子在慢性阻塞性肺疾病急性加重期患者中表达特征的初步研究

Preliminary study on the expression characteristics of serum cortisol and related inflammatory factors in patients with acute exacerbation of chronic obstructive pulmonary disease

目的探讨慢性阻塞性肺疾病急性加重期(AECOPD)患者血清皮质醇(Cor)水平和相关炎症因子的变化及临床意义。方法随机选取2019年3月至2020年6月间在贵港市人民医院住院治疗的62例AECOPD患者为COPD组,根据肺功能检测结果分为轻、中度组30例和重、极重度组32例,另选择同期住院的30例非COPD患者为对照组。全部研究对象均在入院后第二天的上午8点抽血,分别检测血清Cor、促肾上腺皮质激素(ACTH)、C反应蛋白(CRP)、肿瘤坏死因子(TNF)-α及白细胞介素(IL)-8水平。结果与对照组相比,COPD组患者的Cor水平降低,ACTH、CRP、TNF-α及IL-8水平升高,差异有统计学意义(P<0.01)。与轻、中度组相比,重、极重度组患者的ACTH、CRP及TNF-α水平更高,差异有统计学意义(P<0.01),IL-8水平同样更高,但差异无统计学意义(P>0.05)。结论AECOPD患者存在肾上腺皮质功能异常及炎症反应,并与肺功能严重程度有一定相关性。

Objective Objective To investigate the changes and clinical significance of serum cortisol(Cor)level and related inflammatory factors in patients with acute exacerbation of chronic obstructive pulmonary disease(AECOPD).Methods 62 patients with AECOPD hospitalized in People's Hospital of Guigang City from March 2019 to June 2020 were randomly selected as the COPD group.According to the results of pulmonary function tests,patients were divided into mild-moderate group(30 cases)and severe-extremely severe group(32 cases).30 non-COPD patients hospitalized in the same period were selected as the control group.Blood samples were taken for all subjects of study at 8 am on the second day after admission,and levels of serum cortisol(Cor),adrenocorticotropic hormone(ACTH),C-reactive protein(CRP),tumor necrosis factor-α(TNF-α),and interleukin(IL)-8 were measured.Results Compared with the control group,the cortisol level in the COPD group was decreased,and the levels of ACTH,CRP,TNF-α,and IL-8 were increased;and the differences were statistically significant(P<0.01).Compared with the mild-moderate groups,the levels of ACTH,CRP,and TNF-αin the severe-extremely severe group were significantly higher,which was statistically significantly different(P<0.01),and the level of IL-8 was also higher,which,however,was not statistically significant(P>0.05).Conclusion There are adrenal cortical dysfunction and inflammatory response in patients with AECOPD,which is correlated with the severity of lung function.