CAJ | 학술논문

目的探讨老年慢性阻塞性肺疾病急性加重期(AECOPD)患者治疗前后诱导痰中白介素8(IL-8)和IL-10浓度变化及其与气流受限之间的关系;评价激素及β受体激动剂在老年AECOPD治疗中的作用.方法检测132例AECOPD患者入院当日和症状缓解后诱导痰中IL-8和IL-10水平及肺功能(FVC、FVC％ pred、FEV1、FEV1％pred、FEV1/FVC)指标,并进行相关忡分析;随机将患者分为4组,每组33例,分别给予不同治疗,观察各组缓解天数,比较治疗后各组IL-8、IL-10变化水平和肺功能改善程度.结果各组COPD缓解期与加重期IL-8浓度相比差异均有统计学意义(P＜0.001),治疗后各组间IL-8浓度差异有统计学意义(P＜0.001),以激素+β受体激动剂治疗组浓度最低;激素治疗组与激素+β受体激动剂治疗组治疗前后IL-10浓度差异有统计学意义(P＜0.05),后组变化更为显著.治疗后各组间IL-10浓度差异无统计学意义(P＞0.05).未发现IL-8、IL-10水平与某项肺功能指标之间存在相关性.各组临床症状缓解时间以激素+β受体激动剂治疗组最短,但各组间差异无统计学意义.结论 IL-8和IL-10参与了慢性阻塞性肺疾病(COPD)患者的炎症过程,IL-8升高是AECOPD的主要指标,吸入激素治疗可以降低气道内IL-8水平,升高1L-10水平,激素联合β受体激动剂雾化吸入治疗AECOPD的疗效优于单一激素.
목적 탐토노년만성조새성폐질병급성가중기(AECOPD)환자치료전후유도담중백개소8(IL-8)화IL-10농도변화급기여기류수한지간적관계;평개격소급β수체격동제재노년AECOPD치료중적작용.방법 검측132례AECOPD환자입원당일화증상완해후유도담중IL-8화IL-10수평급폐공능(FVC、FVC％ pred、FEV1、FEV1％pred、FEV1/FVC)지표,병진행상관충분석;수궤장환자분위4조,매조33례,분별급여불동치료,관찰각조완해천수,비교치료후각조IL-8、IL-10변화수평화폐공능개선정도.결과 각조COPD완해기여가중기IL-8농도상비차이균유통계학의의(P＜0.001),치료후각조간IL-8농도차이유통계학의의(P＜0.001),이격소+β수체격동제치료조농도최저;격소치료조여격소+β수체격동제치료조치료전후IL-10농도차이유통계학의의(P＜0.05),후조변화경위현저.치료후각조간IL-10농도차이무통계학의의(P＞0.05).미발현IL-8、IL-10수평여모항폐공능지표지간존재상관성.각조림상증상완해시간이격소+β수체격동제치료조최단,단각조간차이무통계학의의.결론 IL-8화IL-10삼여료만성조새성폐질병(COPD)환자적염증과정,IL-8승고시AECOPD적주요지표,흡입격소치료가이강저기도내IL-8수평,승고1L-10수평,격소연합β수체격동제무화흡입치료AECOPD적료효우우단일격소.
Objective To investigate the change of induced sputum interleukin 8 (IL-8),IL-10 level before and after the treatment and its relationship with airflow obstructive in elderly patients with acute stage of chronic obstructive pulmonary disease (AECOPD).To evaluate the effect of corticosteroid and β-adrenoceptor agonist in this disease.Methods Lung functions,IL-8 and IL-10 level of induced sputum was examined in 132 AECOPD patients on admission and after treatment.Relationship between sputum IL-8,IL- 10 level and airflow obstruction indexes (FVC,FVC％ pred,FEV1,FEV1％ pred,FEV1/FVC) was analyzed.132 subjects were randomly divided into four groups with 33 patients for each,i.e. the treatment 1 group,the treatment 2 group,the treatment 3 group and the control group with different treatment.The admission period,medical expenditure,change of pulmonary functions,induced sputum IL-8 and IL- 10 level after treatment in these groups was compared.Results It was observed in each group that the level of sputum IL-8 in acute stage was significantly higher than that in remission stage ( P ＜0.001). After treatment,IL-8 level was statistically and significantly changed in each group ( P ＜0.001).In all groups,the IL-8 level in treated with corticosteroid and β-adrenoceptor agonist was the lowest.After treatment,IL-10 level was statistically and significantly changed in two groups which were treated with corticostcroid ( P＜0.05).This change was more obvious in treatment with corticosteroid and β-adrenoceptor agonist group ( P ＜0.01).After treatment,IL-10 level was no significant difference in each group (P ＞0.05).There was no relationship between the level of IL-8,IL-10 and pulmonary function indexes.Treatment with corticosteroid aud β-adrenoceptor agonist has significant therapeutic effect,rapid relieving symptoms,but no statistical difference with other groups ( P ＞0.05).Conclusions It is indicated that IL-8 and IL-10 was involved in the airway inflammation of COPD.The level of IL-8 may be a key parameter for AECOPD.Treatment with inhaled corticosteroid was a method to increase the local expression of IL-10 and decrease the local expression of IL-8,but combination with corticosteroid and β-adrenoceptor agonist in AECOPD had better effects than single corticosteroid.