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目的观察慢性阻塞性肺疾病(COPD)患者血清及肺泡巨噬细胞(AM)相关细胞因子水平变化。方法选择115例COPD患者和58名健康体检者为研究对象,其中稳定期COPD 59例,急性加重期COPD患者56例,应用酶联免疫吸附(ELISA)法检测血清和AM中白细胞介素(IL)-1β、IL-4、IL-6、IL-8、IL-10、IL-32、干扰素(IFN-γ)和肿瘤坏死因子α(TNF-α)含量,胶体金法测定C-反应蛋白(CRP)含量。结果与健康对照组比,急性加重期COPD组患者血清炎性因子IL-6、IL-8、IL-32、IFN-γ和CRP含量均明显增高,IL-4、IL-10和IL-18含量明显降低,差异均有统计学意义(P<0.01),而AM释放除IL-1β和IL-32以外的炎性因子变化趋势与血清中一致;稳定期COPD组患者IL-6和CRP含量明显增高,IL-10和IL-18含量明显降低,差异均有统计学意义(P<0.01),其他炎性因子变化均无明显差异,而AM释放除的炎性因子变化趋势与血清中一致。急性加重期COPD组患者血清除IL-4、IL-10和IL-18含量明显低于稳定期COPD组,其余炎性因子均较高,同时这种变化趋势也体现在AM释放的除IL-1β和IL-32以外的炎性因子中。结论急性加重期COPD患者血清和AM中的促炎性细胞水平均增高,抗炎性因子降低,而稳定期COPD患者炎症状态较低,呈现出低水平的抗炎性因子。
Objective To observe the changes of serum and alveolar macrophage (AM) related cytokines in patients with chronic obstructive pulmonary disease (COPD). Methods One hundred and fifteen patients with COPD and 58 healthy subjects were selected as study subjects, including 59 stable COPD patients and 56 acute exacerbation COPD patients. Serum and AM interleukin (IL) levels were measured by enzyme-linked immunosorbent assay (ELISA) ) -1β, IL-4, IL-6, IL-8, IL-10, IL-32 and IFN-γ and TNF- Protein (CRP) content. Results Compared with healthy control group, the levels of serum inflammatory cytokines IL-6, IL-8, IL-32, IFN-γ and CRP were significantly increased in patients with acute exacerbation of COPD and the levels of IL-4, IL-10 and IL- (P <0.01). The change trend of inflammatory cytokines except IL-1β and IL-32 released by AM was the same as that in serum. The levels of IL-6 and CRP in patients with stable COPD (P <0.01). There was no significant difference in other inflammatory factors, but the change trend of inflammatory factors released by AM was the same as that in serum . Serum levels of IL-4, IL-10 and IL-18 in patients with acute exacerbation of COPD were significantly lower than that of patients in stable COPD group, and the other inflammatory factors were all higher, 1β and IL-32. Conclusions Patients with exacerbation of exacerbation COPD patients have higher levels of proinflammatory cells in serum and AM, lower anti-inflammatory cytokines, while patients with stable COPD have lower inflammatory state and lower levels of anti-inflammatory cytokines.