血清PCT、IL—1、IL—6在慢性阻塞性肺疾病中的表达及临床意义

徐德华

[摘要]目的 探讨血清降钙素原（PCT）、白细胞介素1（IL-1）、IL-6在慢性阻塞性肺疾病（COPD）中的表达及临床意义。方法 选择2016年1～10月在我院诊治的30例慢性阻塞性肺疾病急性加重期患者作为AECOPD组，30例COPD稳定期患者作为COPD组，同期的30例健康体检者作为对照组，检测三组的血清PCT、IL-1、IL-6水平，分析其与肺功能的相关性。结果 AECOPD组的PCT、IL-1、IL-6水平高于COPD组和对照组，COPD组的PCT、IL-1、IL-6水平高于对照组，差异有统计学意义（P<0.05）。AECOPD组的FEV1%、FEV1/FVC水平均低于COPD组和对照组，COPD组的FEV1%、FEV1/FVC水平均低于对照组，差异有统计学意义（P<0.05）。血清PCT、IL-1、IL-6表达水平与肺功能指标中的FEV1%、FEV1/FVC均成负相关，差异有统计学意义（P<0.05）。结论 COPD患者的血清PCT、IL-1、IL-6随着病情严重程度增加而升高，表达水平与肺功能指标FEV1%、FEV1/FVC均成负相关。检测以上因子水平可反映出病情严重程度，有助于评估病情、指导临床治疗。

[关键词]慢性阻塞性肺疾病；降钙素原；白细胞介素1；白细胞介素6；肺功能

[中图分类号] R563.9 [文献标识码] A [文章编号] 1674-4721（2017）07（b）-0030-03

[Abstract]Objective To investigate the expression and clinical significance of serum procalcitonin （PCT），interleukin-1 （IL-1） and interleukin-6 （IL-6） in chronic obstructive pulmonary disease.Methods From January to October in 2016，30 patients with acute exacerbation of chronic obstructive pulmonary disease （AECOPD） were classified into the AECOPD group，30 patients with stable COPD were selected as the COPD group，and another group of 30 healthy participants for physical examination was selected as the control group in the same period.The indexes of serum PCT，IL-1 and IL-6 were tested and their correlations with pulmonary function were analyzed.Results In the AECOPD group，the levels of serum PCT，IL-1 and IL-6 were significantly higher than those in the COPD group and in the control group，while in comparison of the control group，those in the COPD group were higher，which were both displayed statistical difference （P<0.05）.The level of FEV1% and FEV1/FVC in the AECOPD group was lower compared with those in the COPD group and in the control group，the level of FEV1% and FEV1/FVC in the COPD group was lower than that in the control group，with significant difference （P<0.05）.Expression levels of serum PCT，IL-1 and IL-6 were negatively correlated with FEV1% and FEV1/FVC in pulmonary function，with statistical difference （P<0.05）.Conclusion The levels of serum PCT，IL-1 and IL-6 in COPD patients are increased with the severity of COPD，and the expression levels are in negative correlations with FEV1% and FEV1/FVC.Detection of the above-mentioned factors can reflect the severity of the COPD and assist on assessing the disease condition and guiding the clinical treatment.

[Key words]Chronic obstructive pulmonary disease；Procalcitonin；Interleukin-1；Interleukin-6；Pulmonary function

慢性阻塞性肺疾病（chronic obstructive pulmonary diseases，COPD）是一種以气道炎性损伤和气道重塑为特征的疾病[1]，在COPD的发病机制中，存在多种炎症细胞激活后释放出炎症因子引起肺组织进行性破坏的机制，相关的炎症因子包括肿瘤坏死因子（TNF）、白介素（IL）等[2]。细菌毒素和炎症因子刺激降钙素原（PCT）大量分泌，其可以作为炎症反应的标志物之一。本研究通过检测COPD患者血清PCT和IL-1、IL-6的表达水平，分析其与肺功能指标的关联性，以期为COPD的临床诊治提供依据。

1资料与方法

1.1一般资料

选择2016年1～10月本院诊治的60例COPD患者，均符合2013年《慢性阻塞性肺疾病診治指南》的诊断标准[3]。患者近期未使用糖皮质激素，排除合并其他严重心肝肾疾病、肿瘤及自身免疫性疾病。根据病情将入选患者分为COPD组和AECOPD组，各30例。COPD稳定期指患者咳嗽、咳痰、气短等症状稳定或轻微；COPD急性加重期是指在疾病过程中，患者短期内咳嗽、咳痰、气短和喘息加重，痰量增多，呈脓性或粘液脓性，可伴发热等炎症明显加重表现。……