慢性阻塞性肺疾病前驱性呼吸衰竭患者细胞因子的改变

Cytokine profiles in peripheral blood mononuclear cells in patients with chronic obstructive pulmonary disease at stage of pre-respiratory failure

目的 探讨慢性阻塞性肺疾病 (COPD)前驱性呼吸衰竭 (前驱呼衰 )患者细胞因子谱特征 ,并评价界定COPD前驱呼衰的临床意义。方法 随机选取健康对照者、COPD尚未达前驱呼衰患者、COPD前驱呼衰患者各 30例 ,用双抗体夹心酶联免疫吸附法 (ELISA)测定其外周血单个核细胞经植物血凝素刺激培养后的白细胞介素 4 (IL - 4 )、白细胞介素 8(IL - 8)、γ干扰素 (IFN -γ)的水平。结果 在正常对照、COPD未达前驱呼衰和COPD前驱呼衰三组人群中 ,IL - 8水平依次显著升高 ,其中后组与前两组相比较 ,P均 <0 .0 1,前两组比较P =0 .0 2 1;IFN -γ水平依次显著升高 ,其中后组与前两组相比较 ,P均 <0 .0 1,前两组比较亦为P <0 .0 1;IL - 4水平在三组人群中无统计学差异。结论 (1)IL - 8和IFN -γ在COPD气道炎症的发生发展和气流阻塞中起着重要作用 ,可作为判断病情严重程度的指标。 (2 )界定COPD前驱呼衰阶段具有一定的临床意义 ,加强上述指标的监测有助于及时判断病情并采取措施。

Objective To describe cytokine profiles in patients with chronic obstructive pulmonary disease(COPD) at stage of pre-respiratory failure.Methods 30 healthy control and 30 patients with COPD and 30 COPD with pre-respiratory failure were enrolled . Peripheral blood mononuclear cells(PBMC) were obtained and PHA-induced IL-4,IL-8 and IFN-γ concentration in cultures of PBMC were measured by sandwich ELISA. Results In COPD pre-respiratory failure group,IL-8 level was significantly increased,higher than theses of the control group and COPD group (P<0.01),IL-8 level in the COPD group was significantly increased as compared with that in the control (P=0.021);In COPD pre-respiratory failure group,IFN-γ concentration was markedly higher than that in the other two groups (P<0.01),IFN-γ level in the COPD group was also significantly increased compared with that in the control group (P<0.01);There was no statistical difference in IL-4 level in the three group persons. Conclusions (1)Throughout COPD,both IL-8 and IFN-γ play important roles in the formation and progressing of airway inflammation and airway obstruction. So they might be the parameters which are used to evaluate the serious degree of the disease.(2)The COPD pre-respiratory failure stage is indeed a critical one. Monitoring the changes of all above parameters might help us to evaluate the degree of COPD and to take measures to cure the disease.