TOPD与COPD系统性及气道炎症因子的差异性研究

The Difference Between TOPD and COPD Systemic and Airway Inflammatory Factors

目的研究肺结核相关的慢性阻塞性肺疾病(TOPD)以及慢性阻塞性肺疾病(COPD)系统性及气道炎症因子的差异性。方法选择宝安区中心医院呼吸科住院的TOPD患者及COPD患者各50例,分别记作肺结核相关单纯COPD组及单纯COPD组。检测并比较两组血清、痰液白细胞介素-6(IL-6)、白细胞介素-8(IL-8)、肿瘤坏死因子-α(TNF-α)以及基质金属蛋白酶-9(MMP-9)水平,肺功能指标水平。并以Pearson相关性分析明确FEV_(1)/FVC、FEV_(1)%pred与IL-6、IL-8、TNF-α、MMP-9水平的关系。结果肺结核相关单纯COPD组血清IL-6、IL-8、TNF-α以及MMP-9水平分别为(45.18±5.91)ng/L、(126.28±10.37)pg/mL、(56.29±6.92)pg/mL、(244.05±31.22)ng/mL,均高于单纯COPD组的(34.17±3.25)ng/L、(101.25±8.47)pg/mL、(40.81±4.71)pg/mL、(221.38±25.29)ng/mL(P<0.05)。肺结核相关单纯COPD组痰液IL-6、IL-8、TNF-α以及MMP-9水平分别为(31.09±4.34)ng/L、(71.51±6.33)pg/mL、(41.35±3.14)pg/mL、(173.66±22.18)ng/mL,均高于单纯COPD组的(20.21±3.11)ng/L、(52.34±4.29)pg/mL、(28.62±2.66)pg/mL、(145.16±18.71)ng/mL(P<0.05)。经Pearson相关性分析发现,FEV_(1)/FVC、FEV_(1)%pred与IL-6、IL-8、TNF-α、MMP-9水平均呈负相关关系(P<0.05)。结论TOPD与COPD系统性和气道炎症因子存在明显的差异性,且肺功能亦有所差异,值得临床重点关注。

Objective To study the differences of systemic and airway inflammatory factors in pulmonary tuberculosis related chronic obstructive pulmonary disease(TOPD)and chronic obstructive pulmonary disease(COPD).Methods 50 TOPD patients and 50 COPD patients were enrolled in the respiratory department of Baoan District Central Hospital,and were recorded as tuberculosis related simple COPD group and simple COPD group,respectively.Serum and sputum interleukin-6(IL-6),interleukin-8(IL-8),tumor necrosis factor-α(TNF-α),matrix metalloproteinase-9(MMP-9)levels and lung function indexes were detected and compared between the two groups.Pearson correlation analysis was used to determine the relationship between FEV_(1)/FVC,FEV_(1)%PRED and IL-6,IL-8,TNF-α,MMP-9 levels.Results The levels of IL-6,IL-8,TNF-αand MMP-9 were(45.18±5.91)ng/L,(126.28±10.37)pg/mL,(56.29±6.92)pg/mL,(244.05±31.22)ng/mL,respectively,which was higher than those in COPD group(34.17±3.25)ng/L,(101.25±8.47)pg/ml,(40.81±4.71)pg/mL,(221.38±25.29)ng/mL(P<0.05).The levels of IL-6,IL-8,TNF-αand MMP-9 in sputum were(31.09±4.34)ng/L,(71.51±6.33)pg/mL,(41.35±3.14)pg/mL,(173.66±22.18)ng/mL,respectively,which was higher than those in COPD group(20.21±3.11)ng/L,(52.34±4.29)pg/mL,(28.62±2.66)pg/mL,(145.16±18.71)ng/mL(P<0.05).Pearson correlation analysis showed that FEV_(1)/FVC,FEV_(1)%PRED were negatively correlated with IL-6,IL-8,TNF-αand MMP-9 levels(P<0.05).Conclusion There are significant differences between TOPD and COPD systemic and airway inflammatory factors,as well as differences in lung function,which are worthy of clinical attention.