CAJ | 학술논문

目的：观察和分析慢性阻塞性肺疾病（COPD）患者血清可溶性细胞间黏附分子-1（sICAM-1）、炎性因子检测的临床意义。方法选取 COPD 急性加重期（AECOPD）患者60例作为 AECOPD 组，根据治疗前是否合并呼吸衰竭将其分为合并呼衰组和未合并呼衰组2个亚组；选取同期经常规治疗临床症状缓解的 AECOPD 患者60例作为 COPD 稳定期组；选取同期体检结果健康者60例作为对照组。对3组研究对象的血清 sICAM-1、白细胞介素-10（IL-10）、白细胞介素-18（IL-18）水平进行检测和分析。结果 AECOPD 组患者的血清 sICAM-1和 IL-18水平显著高于 COPD 稳定期组（P ＜0．05）；COPD 稳定期组患者的血清 sICAM-1和 IL-18水平显著高于对照组（P ＜0．05）；AECOPD 组患者的血清 IL-10水平显著低于 COPD 稳定期组（P ＜0．05）；COPD 稳定期组患者的血清 IL-10水平显著低于对照组（P ＜0．05）；合并呼衰组患者的血清 sICAM-1和 IL-18水平显著高于未合并呼衰组（P ＜0．05）；合并呼衰组患者的血清 IL-10水平显著低于未合并呼衰组（P ＜0．05）；AECOPD 组患者的血清 IL-10水平与血清 sICAM-1水平呈负相关关系（r ＝-0．53，P ＜0．05），而 AECOPD 组患者的血清 IL-18水平与血清sICAM-1水平呈正相关关系（r ＝0．68，P ＜0．05）。结论血清 sICAM-1和 IL-18水平的上升以及血清 IL-10水平的下降可能与 AECOPD 的发生及其合并呼吸衰竭有相关性，血清 sICAM-1水平的上升可反映患者机体炎性反应的加剧状态。
목적：관찰화분석만성조새성폐질병（COPD）환자혈청가용성세포간점부분자-1（sICAM-1）、염성인자검측적림상의의。방법선취 COPD 급성가중기（AECOPD）환자60례작위 AECOPD 조，근거치료전시부합병호흡쇠갈장기분위합병호쇠조화미합병호쇠조2개아조；선취동기경상규치료림상증상완해적 AECOPD 환자60례작위 COPD 은정기조；선취동기체검결과건강자60례작위대조조。대3조연구대상적혈청 sICAM-1、백세포개소-10（IL-10）、백세포개소-18（IL-18）수평진행검측화분석。결과 AECOPD 조환자적혈청 sICAM-1화 IL-18수평현저고우 COPD 은정기조（P ＜0．05）；COPD 은정기조환자적혈청 sICAM-1화 IL-18수평현저고우대조조（P ＜0．05）；AECOPD 조환자적혈청 IL-10수평현저저우 COPD 은정기조（P ＜0．05）；COPD 은정기조환자적혈청 IL-10수평현저저우대조조（P ＜0．05）；합병호쇠조환자적혈청 sICAM-1화 IL-18수평현저고우미합병호쇠조（P ＜0．05）；합병호쇠조환자적혈청 IL-10수평현저저우미합병호쇠조（P ＜0．05）；AECOPD 조환자적혈청 IL-10수평여혈청 sICAM-1수평정부상관관계（r ＝-0．53，P ＜0．05），이 AECOPD 조환자적혈청 IL-18수평여혈청sICAM-1수평정정상관관계（r ＝0．68，P ＜0．05）。결론혈청 sICAM-1화 IL-18수평적상승이급혈청 IL-10수평적하강가능여 AECOPD 적발생급기합병호흡쇠갈유상관성，혈청 sICAM-1수평적상승가반영환자궤체염성반응적가극상태。
Objective To observe and analyze clinical significance of detection of serum sol-uble intracellular adhesion molecule-1 (sICAM-1),inflammatory mediators levels for the patients with chronic obstructive pulmonary disease (COPD).Methods 60 patients with acute exacerbated COPD were selected as the AECOPD group and divided into complicated with respiratory failure group and the without complicated respiratory failure group according to whether the patients had been complicated with respiratory failure before the treatment;60 patients with AECOPD whose clinical symptoms were relieved after the routine treatment during the same period were selected as the COPD stable phase group;60 patients with healthy examination results during the same period were selected as the control group.The serum levels of sICAM-1,interleukin-10 (IL-10),inter-leukin-18 (IL-18)of the subjects in the three groups were detected and analyzed.Results The serum sICAM-1 and IL-18 levels of the patients in the AECOPD group were significantly higher than those of the COPD stable phase group (P <0.05)and the serum sICAM-1 and IL-18 levels of the patients in the COPD stable phase group were significantly higher than those of the control group (P <0.05);The serum IL-10 level of the patients in the AECOPD group was significantly lower than that of the COPD stable phase group (P <0.05)and the serum IL-10 level of the patients in the COPD stable phase group was significantly lower than that of the control group (P < 0 .0 5 );The serum sICAM-1 and IL-1 8 levels of the patients in the complicated with respiratory failure group were significantly higher than those of the without complicated respirato-ry failure group (P <0.05)and the serum IL-10 level of the patients in the complicated with res-piratory failure group was significantly lower thanthat of the without complicated respiratory fail-ure group (P <0.05);In the AECOPD group,the serum IL-10 level was negative related with the serum sICAM-1 level of (r =-0.53,P <0.05),while the serum IL-18 level was positively related with the serum sICAM-1 level (r =0.68,P <0.05).Conclusion The increased serum sICAM-1 and IL-18 levels and the decreased serum IL-10 level may be associated with the occur-rence of AECOPD and the complicated respiratory failure.The increasing of the serum sICAM-1 level can reflect the state of the inflammatory reaction of patients.