COPD伴或不伴低氧血症患者血清白介素-17与8-异前列腺素F2α及认知功能损伤情况研究

摘要

Objective To investigate the association of the serum level of interleukin-17 (IL-17) and 8-isoprostaglandin (8-iso-PGF2α) and cognitive function in chronic obstructive pulmonary disease patients with or without hypoxemia. Methods 74 COPD patients from January, 2016 to March, 2018 were enrolled. According to blood gas analysis, they were divided into the hypoxemia group (25 cases) and the non-hypoxemia group (37 cases). Another30 cases who received physical examination were selected as the control group during the same period. The serum level of IL-17, 8-iso-PGF2α and the Montreal cognitive assessment scale (MoCA scale) were respectively evaluated among the three groups. The correlation of serum IL-17, 8-iso-PGF2α and MoCA score and blood oxygen partial pressure was analyzed. Results The serum levels of IL-17 and 8-iso-PGF2α in the COPD group were higher than that in the control group, and the total score of MoCA was lower in the COPD group than the control group. Among them, the increase of serum levels of IL-17 and 8-iso-PGF2α and the decrease of MoCA score were more pronounced in the hypoxemia group (all P ＜ 0.05). The levels of serum IL-17 and 8-iso-PGF2α were negatively correlated with the total score of MoCA (r =-0.642, -0.680, P ＜ 0.05), and they were positively correlated with the blood oxygen partial pressure (r =-0.658, -0.651, P ＜ 0.05). The blood oxygen partial pressure was positively correlated with MoCA score (r = 0.633, P ＜ 0.05). Conclusion The levels of serum IL-17 and 8-iso-PGF2α in patients with chronic obstructive pulmonary disease are positively correlated with the degree of cognitive dysfunction, suggesting that hypoxemia may be one of the factors that induces the systemic inflammatory response and cognitive impairment in patients with chronic obstructive pulmonary disease.%目的 探讨慢性阻塞性肺疾病(简称慢阻肺)伴或不伴低氧血症患者血清白介素-17(Interleukin-17,IL-17)与8-异前列腺素(8-iso-prostaglandin-F2α,8-iso-PGF2α)水平及认知功能损伤情况.方法 纳入2016年1月至2018年3月于华北理工大学附属医院住院的74例慢阻肺患者,记录患者血气分析结果,依据血气分析将其分为慢阻肺低氧血症组(25例)和慢阻肺无低氧血症(37例),同期30例健康体检人群为对照组.检测三组人群血清IL-17、8-iso-PGF2α浓度及蒙特利尔认知评估量表(MoCA量表)认知得分.分析三组人群上述指标变化,分析血清IL-17、8-ISO-PGF2α与MoCA评分及血气氧分压的相关性分析.结果 慢阻肺患者血清IL-17、8-ISO-PGF2α水平高于对照组,MoCA评分总分较对照组低,其中低氧血症组血清IL-17、8-ISO-PGF2α水平增高及MoCA评分降低更明显,差异有统计学意义(均P ＜0.05).血清IL-17、8-ISO-PGF2α水平与MoCA总分呈负相关(r=-0.642,-0.680,P ＜0.05),血清IL-17、8-ISO-PGF2α水平与血气氧分压呈负相关(r=-0.658,-0.651,P ＜0.05),慢阻肺伴或不伴低氧血症患者血气分压与MoCA评分呈正相关性(r=0.633,P ＜0.05).结论 与慢阻肺无低氧血症组比较,慢阻肺伴低氧血症患者,血清IL-17、8-ISO-PGF2α水平及MoCA改变更明显,血清IL-17、8-ISO-PGF2α水平与MoCA总分存在负相关,且血气分压与MoCA评分呈正相关性,提示低氧血症可能是促进慢阻肺患者血清IL-17、8-ISO-PGF2α增高的因素之一,并可能在患者认知功能受损中发挥作用.