CAJ | 학술논문

目的：探讨COPD急性加重期和稳定期血清炎性因子水平变化及其与肺功能的关系。方法收集我院2010年3月-2013年9月呼吸内科确诊的COPD患者450例，依据其临床阶段分为急性加重期（207例）和稳定期（243例），并以本院体检科体检健康者100例为对照组，比较各组炎性因子水平、肺功能指标，肺功能分级与炎性因子的关系采用多分类Logistic回归分析。结果与对照组比较，稳定期COPD患者白介素（ IL）-2降低，干扰素γ（ IFN-γ）、结缔组织生长因子（ CTGF）升高，急性加重期COPD患者IL-1β、IL-8、肿瘤坏死因子α（ TNF-α）、IFN-γ、CTGF升高，IL-2降低（P<0.05）；与稳定期比较，急性加重期COPD患者IL-1β、IL-8、TNF-α、IFN-γ和CTGF升高，IL-2降低（ P<0.05）。稳定期和急性加重期COPD患者较对照组一秒用力呼气容积（ FEV1）、FEV1/用力肺活量（FVC）和FEV1占预计的百分比值降低（P<0.05）；急性加重期较稳定期COPD患者FEV1、FEV1/FVC和FEV1占预计值的百分比降低（ P <0.05）。多分类 Logistic 回归分析结果显示， IL -1β、IL -2、IL -8、TNF-α、IFN-γ和CTGF与肺功能有回归关系（ P<0.05）。结论 IL-1β、IL-8、TNF-α、IFN-γ和CTGF升高是COPD急性加重的主要指标，对指导临床治疗COPD 和其严重程度的判断有一定意义。
목적：탐토COPD급성가중기화은정기혈청염성인자수평변화급기여폐공능적관계。방법수집아원2010년3월-2013년9월호흡내과학진적COPD환자450례，의거기림상계단분위급성가중기（207례）화은정기（243례），병이본원체검과체검건강자100례위대조조，비교각조염성인자수평、폐공능지표，폐공능분급여염성인자적관계채용다분류Logistic회귀분석。결과여대조조비교，은정기COPD환자백개소（ IL）-2강저，간우소γ（ IFN-γ）、결체조직생장인자（ CTGF）승고，급성가중기COPD환자IL-1β、IL-8、종류배사인자α（ TNF-α）、IFN-γ、CTGF승고，IL-2강저（P<0.05）；여은정기비교，급성가중기COPD환자IL-1β、IL-8、TNF-α、IFN-γ화CTGF승고，IL-2강저（ P<0.05）。은정기화급성가중기COPD환자교대조조일초용력호기용적（ FEV1）、FEV1/용력폐활량（FVC）화FEV1점예계적백분비치강저（P<0.05）；급성가중기교은정기COPD환자FEV1、FEV1/FVC화FEV1점예계치적백분비강저（ P <0.05）。다분류 Logistic 회귀분석결과현시， IL -1β、IL -2、IL -8、TNF-α、IFN-γ화CTGF여폐공능유회귀관계（ P<0.05）。결론 IL-1β、IL-8、TNF-α、IFN-γ화CTGF승고시COPD급성가중적주요지표，대지도림상치료COPD 화기엄중정도적판단유일정의의。
Objective To explore the correlation between level of serum inflammation factors and pulmonary function in patients with acute exacerbation and stable stage of COPD. Methods From March 2010 to September 2013 , patients with COPD who were diagnosed in department of respiratory internal medicine of our hospital were selected as study subjects. According to the clinical stage,the patients was divided into acute exacerbation group(207 cases)and stable stage group(243 cases), 100 healthy people from department of health examination were selected as control group. The levels of inflammatory factors and pulmonary function examination indicators were compared among various groups,and multinomial Logistic regression analysis were performed to identify the correlation between level of serum inflammation factors and pulmonary function. Results Compared with the control group,the levels of IL-2 in stable stage group decreased,the levels of IFN- γand CTGF in stable stage group in-creased(P<0. 05). Compared with stable stage group,the levels of IL-1β,IL-8,TNF- α,IFN- γand CTGF in acute exacerbation group increased,the levels of IL-2 in acute exacerbation group decreased(P<0. 05). FEV1,FEV1/FVC and FEV1/ expected value in stable stage group and acute exacerbation group were significantly lower than those in control group( P<0. 05). FEV1 ,FEV1/FVC and FEV1/ expected value in acute exacerbation group were significantly lower than those in stable stage group(P<0. 05). Multiple Logistic regression analysis results showed that there was a marked regression relationship be-tween levels of IL-1 β,IL-2,IL-8,TNF-α,IFN- γ,CTGF and pulmonary function(P<0. 05). Conclusion The increased levels of IL-1β,IL-8,TNF-α,IFN-γ and CTGF may be the main markers for acute exacerbation of COPD, which could guide the clinical treatment of COPD and have certain significance in judging the severity of COPD.