急性加重期慢性阻塞性肺疾病患者肺气肿表型肺功能及痰细胞因子水平及其关系研究

摘要

Objective:To investigate the changes of lung function and sputum cytokine levels in patients with chronic obstructive pulmonary disease (COPD) and their correlation with the degree of pulmonary emphysema.Methods:Selected respiratory medicine hospital in January 2014 to September 2015 COPD patients admitted to 240 cases,113 cases are divided into groups with and without emphysema emphysema combined with emphysema index based on high-resolution CT (HRCT) findings group of 87 cases,collate and analyze differences in lung function in patients with two levels of inflammatory cytokines in sputum supernatant and analyzed the relationship between the degree of emphysema patients.Results:Group of patients with emphysema FEV1/FVC,FEV1％ pred were significantly lower than that of patients without emphysema group (P ＜0.05),significantly higher than in patients without emphysema PaCO2 levels (P ＜ O.05);lung swelling group of patients sputum supematant IL-8,IL-6,TNF-c,MMP-9,TIMP-1 levels were significantly higher than those without emphysema patients and the difference was statistically significant (P ＜ 0.05);emphysema patients sputum supernatant IL-8,IL-6,MMP-9,TIMP-1,PaO2 levels and emphysema index EI was no significant correlation (P ＞ O.05);pulmonary emphysema function parameters FEV1/ FVC,FEV1 ％ pred with the patient's emphysema index EI was a significant negative correlation (P ＜ 0.05),patients with emphysema PaCO2,sputum supernatant TNF-α levels in patients with emphysema index EI There was a significant positive correlation (P ＜ 0.05).Conclusion:Emphysema type COPD patients significantly lower lung function than those without COPD patients with emphysema,while the degree of emphysema and lung function and sputum TNF-α levels have a certain relationship.%目的:探讨慢性阻塞性肺疾病(COPD)患者肺气肿表型患者的肺功能、痰细胞因子水平变化及与患者肺气肿程度的相关性.方法:选取本院呼吸内科2014年1月至2015年9月,收治240例COPD患者,根据高分辨率CT(HRCT)检查结果结合肺气肿指数(EI)分为肺气肿组113例和无肺气肿组87例,整理并分析两组患者的肺功能指标、痰上清液中炎症细胞因子水平的差异,并分析与患者肺气肿程度的关系.结果:肺气肿组患者的FEV1/FVC、FEV1％水平显著的低于无肺气肿组患者(P＜0.05),PaCO2水平显著的高于无肺气肿组患者(P＜0.05);肺气肿组患者痰上清液IL-8、IL-6、TNF-α、MMP-9、TIMP-1的水平显著的高于无肺气肿组患者且差异有统计学意义(P＜0.05);肺气肿组患者痰上清液IL-8、IL-6、MMP-9、TIMP-1、PaO2的水平与肺气肿指数EI差异无统计学意义(P＞0.05);肺气肿患者肺功能指标FEV1/FVC、FEV1％与患者的肺气肿指数EI差异有统计学意义(P＜0.05),肺气肿患者PaCO2、痰上清液TNF-α水平与患者肺气肿指数EI差异有统计学意义(P＜0.05).结论:肺气肿型COPD患者的肺功能显著的降低较无肺气肿COPD患者,同时肺气肿程度与肺功能指标及痰液中TNF-α水平有一定的关系.