不同时期慢性阻塞性肺疾病患者评估测试量表评分、肺功能与呼出气冷凝液中白细胞介素17、白细胞介素8的相关性

摘要

目的 探讨不同时期慢性阻塞性肺疾病(chronic obstructive pulmonary disease, COPD)评估测试量表(CAT)评分、肺功能与呼出气冷凝液(EBC)中白细胞介素17(IL-17)、白细胞介素8(IL-8)的相关性.方法 选取急性加重期COPD 81例作为COPD组,急性加重期COPD患者经14 d左右正规抗感染及雾化吸入等对症处理病情明显缓解后视为稳定期.另选取同期78例健康体检者作为健康对照组.观察比较COPD组急性加重期与稳定期,以及COPD组急性加重期及稳定期与健康对照组EBC中IL-8,IL-17水平及肺功能情况,并对COPD组急性加重期及稳定期EBC 中IL-17、IL-8水平与CAT 评分、FEV1/预计值,CAT 评分与FEV1/预计值,以及COPD患者EBC中IL-17、IL-8、CAT评分从急性加重期到稳定期改善程度与FEV1/预计值从急性加重期到稳定期改善程度的关系进行分析.结果 COPD组急性加重期EBC中IL-17和IL-8水平显著高于稳定期,FEV1/预计值明显低于稳定期,差异有统计学意义(P<0.05).COPD组急性加重期、稳定期EBC中IL-17和IL-8水平均明显高于健康对照组,FEV1/预计值均明显低于健康对照组,差异具有统计学意义(P<0.05).COPD患者急性加重期及稳定期EBC中IL-17和IL-8水平与CAT评分均呈明显正相关.COPD患者EBC中IL-17、IL-8水平及CAT评分从急性加重期到稳定期改善程度与FEV1/预计值从急性加重期到稳定期改善程度呈正相关.结论 COPD患者CAT评分越高,EBC中IL-17、IL-8水平越高,疾病严重程度越重,患者生活质量明显下降.EBC中IL-17、IL-8水平结合肺功能指标检测及CAT评分可客观、无创地评价COPD患者病情严重程度及生活质量水平.%Objective To investigate the correlation of CAT score and lung function to interleukin-17 (IL-17) and interleukin-8 (IL-8) in exhaled breath condensate (EBC) in patients with chronic obstructive pulmonary disease (COPD) at different periods. Methods Eighty-one acute COPD exacerbations (AECOPD) patients were selected as the study group,whereas 78 healthy people were taken as the control group. After 14 d of regular anti-in-fective and symptomatic treatment, symptoms of AECOPD patients at acute exacerbation period was significantly re-lieved,which was referred to as a stable period. The levels of IL-17 and IL-8 in EBC and lung function were meas-ured and compared between the AECOPD group, stable COPD group and control group. The relationship of IL-17 and IL-8 in EBC to CAT score and the forced expiratory volume (FEV) in one second/predicted value ratio (FEV1% pred) in AECOPD group and stable group was analyzed. The relationship of CAT score and FEV1% pred in AECOPD group and stable group was analyzed. The relationship between the improvement in IL-17 and IL-8 in EBC as well as in CAT score from acute exacerbation to stable phase was analyzed and the improvement in FEV1% pred from acute exacerbation to stable phase was analyzed. Results The levels of IL-8 and IL-17 in EBC of AECOPD group were significantly higher but the levels of FEV1% pred were significantly lower than those in stable group(P<0.05). The levels of IL-8 and IL-17 in EBC were significantly higher and the levels of FEV1% pred were remarkably lower in AECOPD group and stable group than in control group(P<0.05). There was a positive correlation of CAT score to IL-17 and IL-8 in the EBC of AECOPD group and stable group. Additionally,there was a positive correlation of the improvement of IL-8 and IL-17 in EBC and CAT score to FEV1% pred from acute exacerbation period to stable period (P<0.05). Conclusion In COPD patients,higher level of IL-17 and IL-8 in EBC and higher CAT score contributes to more serious disease and poorer life quality. The lung functional indicators, IL-17 and IL-8 in EBC, and CAT score can be objective and noninvasive in the evaluation of severity and life quality of COPD patients.