COPD患者气道炎性标记物与咳嗽、咳痰的相关性

Correlation between the levels of inflammatory markers and symptom of cough and phlegm of patients with chronic obstructive pulmonary disease

目的探讨慢性阻塞性肺疾病(COPD)患者痰液及气道中炎性标记物(中性粒细胞比例、嗜酸性粒细胞比例及趋化因子Eotaxin、RANTES)水平与咳嗽、咳痰的相关性。方法选取安岳县人民医院2016年9月至2017年10月确诊的COPD患者为研究对象,将有咳嗽、咳痰症状的患者作为观察组,将仅有咳嗽,但无咳痰症状患者作为阳性对照组,将无咳嗽、咳痰患者作为阴性对照组,收集合格痰液标本,分别检测痰液上清液Eotaxin、RANTES水平及计数痰涂片各细胞成分比例。结果 86例取得合格痰标本患者中,观察组痰上清液Eotaxin水平[(7.45±1.47)pg/mL]明显高于阳性对照组[(4.17±1.03)pg/mL]及阴性对照组[(2.03±0.55)pg/mL],差异均有统计学意义(P<0.05);阳性对照组也明显高于阴性对照组,差异有统计学意义(P<0.05);观察组RANTES水平[(7.11±2.13)pg/mL]明显高于阳性对照组[(4.23±1.32)pg/mL]及阴性对照组[(2.55±0.47)pg/mL)],差异有统计学意义(P<0.05);阳性对照组高于阴性对照组,差异有统计学意义(P<0.05);在痰涂片中,观察组中性粒细胞[(4.62±1.07)×106cells/mL]高于阳性对照组[(3.03±0.82)×10~6cells/mL]及阴性对照组[(2.37±0.71)×10~6cells/mL],差异有统计学意义(P<0.05);观察组嗜酸性粒细胞[(0.23±0.06)×10~6cells/mL]与阳性对照组[(0.19±0.04)×10~6cells/mL]差异无统计学意义(P>0.05);观察组与阴性对照组[(0.18±0.05)×10~6cells/mL]比较,差异有统计学意义(P<0.05);阳性对照组与阴性对照组比较,差异无统计学意义(P>0.05)。结论中性粒细胞、嗜酸性粒细胞及其趋化因子Eotaxin、RANTES等气道炎性标记物参与了COPD患者咳嗽、咳痰反应过程,痰中嗜酸性粒细胞趋化因子Eotaxin、RANTES水平与气道炎症程度有关。

Objective To detect the level of airway inflammatory markers[proportion of neutrophils,eosinophils and the level of Eosinophils chemokines(Eotaxin and RANTES)]in sputum,and to research the effect of airway inflammatory markers on the process of symptom of cough and phlegm in patients with chronic obstructive pulmonary disease(COPD).Methods Patients in our center who diagnosed with COPD from September 2016to October 2017were selected.And patients with both symptom of the cough and phlegm were divided to experimental group,while the patients only with the symptom of cough were divided to positive control group,and patients with neither of them were divided into negative control group.The qualified samples were selected,and the level of Eotaxin and RANTES were detected.Proportion of cell components was counted.Results A total of 86patients were collected the qualified sample.Eotaxin level in experimental group[(7.45±1.47)pg/mL]was significantly higher than that of positive control group[(4.17±1.03)pg/mL]and negative control group[(2.03±0.55)pg/mL],and differences were statistically significant(P<0.05).Moreover,Eotaxin level of positive control group was significantly higher than negative control group(P<0.05).The level of RANTES in experimental group[(7.11±2.13)pg/mL]were significantly higher than positive control group[(4.23±1.32)pg/mL]and negative control group[(2.55±0.47)pg/mL],differences were statistically significant(P<0.05).Furthermore,RANTES level of the positive control group was also significantly higher than negative control group(P<0.05).The proportion of Neutrophil cells in experimental group[(4.62±1.07)×106cells/mL]was significantly higher than that of positive control group[(3.03±0.82)×106 cells/mL]and negative control group[(2.37±0.71)×106 cells/mL],differences were statistically significant(P<0.05).The Eosnophils cells of experimental group[(0.23±0.06)×106cells/mL]was higher than the negative control group[(0.18±0.05)×106cells/mL],differences were statistically significant(P<0.05).Conclusion Neutrophils,Eosnophils,Eotaxin and RANTES are all playing substantial roles in the process of symptom of cough and phlegm,and there are positive correlations between the levels of Eotaxin,RANTES and airway inflammation.