TNF—α、TGF—β及IL—10在慢性阻塞性肺疾病患者中的表达及临床意义

刘领 吴文杰 杨霁 李秀业 熊鑫 薛兵

[摘要] 目的 观察肿瘤坏死因子-α（TNF-α）、转化生长因子-β（TGF-β）及白细胞介素-10（IL-10）在慢性阻塞性肺疾病（COPD）患者中的表达及其与病情的关系。 方法 检测2015年1月1日～12月31日我院收住的112例慢性阻塞性肺疾病急性加重（AECOPD）患者血清TNF-α、TGF-β及IL-10水平，并将其与COPD缓解期组及健康对照组比较。观察不同肺功能水平分级AECOPD患者上述炎症因子水平的差异。对AECOPD患者进行CAT评分，比较不同CAT评分组上述炎症因子的差异。 结果 急性加重期组患者血清TNF-α、TGF-β显著性高于缓解期及健康对照组，而IL-10显著性低于缓解期及健康对照组（P<0.05）。缓解期TNF-α、TGF-β及IL-10水平与健康对照组比较，差异有统计学意义（P<0.05）。不同肺功能水平患者TGF-β水平比较，差异有统计学意义（P<0.05）。不同CAT评分组TNF-α、IL-10水平比较，差异有统计学意义（P<0.05）。 结论 TNF-α、TGF-β的升高及IL-10的降低参与了COPD的发生和发展。可能TNF-α主要与气道炎症的急性加重有关，TGF-β主要与气道重塑有关。

[关键词] 慢性阻塞性肺疾病；肿瘤坏死因子-α；转化生长因子-β；白细胞介素-10

[中图分类号] R563 [文献标识码] A [文章编号] 1674-4721（2016）03（c）-0060-03

[Abstract] Objective To observe the relationship between the expression of TNF-α，TGF-β and IL-10 in COPD patients and the state of an illness. Methods The level of serum TNF-α， TGF-β and IL-10 of 112 AECOPD patients from January 1 to December 31 2015 were tested and were compared with COPD in the period of remission stage and health control group.The difference of above inflammatory factors level in AECOPD patients with different level of lung function classification were observed.CAT score of AECOPD patients were conducted and the differences between the CAT groups above inflammation factors were compared. Results The serum TNF-α and TGF-β in AECOPD patients were obvious higher than the patients in the period of remission stage and health control group，but IL-10 obvious lower than in the period of remission stage and health control group（P<0.05）.These inflammatory factors in the period of remission stage also had obvious difference compared with health control group（P<0.05）.The TGF-β had obvious difference among different lung function patients（P<0.05）.The TNF-α and TGF-β had obvious between CAT score groups（P<0.05）. Conclusion The increases of TNF-α and TGF-β and the decreases of IL-10 participate in the occurrence and development of COPD.TNF-α may mainly be related to cute exacerbation of airway inflammation and TGF-β may mainly be related to airway remodeling.

[Key words] Chronic obstructive pulmonary disease；Tumor necrosis factor-α；Transforming growth factor-β；Interleukin-10

慢性阻塞性肺疾病（chronic obstructive pulmonary disease，COPD）是一种以气道慢性炎症为特征的呼吸系统常见疾病，气道炎症细胞释放的多种炎症因子和炎症介质对疾病的发生、发展起着至关重要的作用[1]。本研究观察COPD急性加重期（AECOPD）致炎因子肿瘤坏死因子-α（tumour necrosis factor-α，TNF-α）和转化生长因子-β（transforming growth factor，TGF-β）及抑炎因子白细胞介素-10（interleukin-10，IL-10）的表达，并将其与疾病缓解期及健康人群比较，以观察上述炎症因子与疾病发生、发展的关系。

1 资料与方法

1.1一般资料

选择2015年1月1日～12月31日我院收住的112例AECOPD患者为观察对象，全部病例均包括肺功能在内的完整病历资料，诊断均符合中华医学会呼吸病学会拟定之诊断标准[2]。急性加重判断标准：咳嗽、咳痰、气短或喘息加重，痰量增多，可伴发热等症状。缓解期判定标准：经正规治疗10～14 d症状缓解或稳定，胸部X线无异常，血气分析正常或接近正常，达出院标准[2-3]。……