血清炎症标志物与慢性阻塞性肺疾病及肺功能的关联

Association of Serum Inflammatory Makers with Chronic Obstructive Pulmonary Disease and Lung Function

目的:探究C反应蛋白(CRP)、白介素-6 (IL-6)和白介素-8 (IL-8)与新筛查的慢性阻塞性肺疾病(以下简称慢阻肺)之间的关联及对肺功能指标的影响。方法:2022年8—10月,对上海市松江区社区居民中肺功筛查出的248例慢阻肺患者和1∶1随机抽取的非慢阻肺患者进行血液样本的采集,检测血清CRP、IL-6和IL-8浓度。根据无炎症风险和正常参考值范围将炎症因子浓度分为3个水平。分别使用logistic回归和多重线性回归模型,分析血清炎症标志物水平对慢阻肺患者患病情况和肺功能的影响。结果:共检测207例慢阻肺患者和218名非慢阻肺患者血液样本,有8.9%、5.4%和9.6%的研究对象血清CRP、IL-6和IL-8浓度超出正常参考值范围。logistic回归结果显示,血清CRP浓度>1 mg/L是慢阻肺的危险因素;慢阻肺患者CRP浓度≥5 mg/L时,CRP浓度与肺功能水平呈负相关。血清IL-6和IL-8水平在该人群中未发现与慢阻肺患病情况和肺功能指标有关联。结论:慢阻肺可能是一种全身慢性炎症性疾病,血清CRP水平相比IL-6和IL-8能更好地提示慢阻肺和肺功能损害的危险性。应当注重对CRP水平长期高于1 mg/L人群慢阻肺的早期筛查。

OBJECTIVE To explore the association between CRP,IL-6,and IL-8 levels and newly screened patients with COPD.METHODS From August to October 2022,blood samples were collected from 248 COPD patients and 248 randomly selected non-COPD residents from the Shanghai Suburban Adult Cohort and Biobank who had undertaken a spirometry test and question⁃naire survey.Serum CRP,IL-6,and IL-8 levels were measured for further analysis.The cut-off points for CRP were based on the absence of inflammatory risk and the normal reference range;for IL-6 and IL-8 were based on the lower detection limits and the normal reference range.Multinomial logistics regression was used to evaluate the association between serum inflammatory makers and COPD,and multiple linear regression was used to evaluate the impact on lung function.RESULTS 207 COPD patients and 218 non-COPD residents were finally included.In 8.9%,5.4%,and 9.6%of the participants,respectively,the serum CRP,IL-6,and IL-8 concentrations were outside the normal reference range.Multivariable analysis showed that CRP>1 mg/L was a risk factor for COPD.In COPD patients with CRP≥5 mg/L,there was a negative correlation between CRP and lung function.IL-6 and IL-8 were not associated with COPD and lung function in this population.CONCLUSION COPD might be a chronic systemic inflammatory dis⁃ease.Compared to IL-6 and IL-8,serum CRP performed better in predicting the risk of COPD and lung function decline.Early screening for COPD is needed in people with chronic CRP levels above 1 mg/L.