摘要
目的观察慢性阻塞性肺疾病(COPD)患者痰和血液中炎性细胞和炎症介质的变化是否一致。方法同步收集54例COPD稳定期患者的晨痰和空腹静脉血,其中0级10例、I级10例、II级10例、III级12例和IV级12例;正常对照组(健康志愿者)10例;行痰细胞分类计数和血常规检查;用ELISA夹心法测定诱导痰上清液和血清中的IL-6浓度,用透射比浊法测定诱导痰上清液和血清中的CRP浓度。结果COPD各组痰细胞总数、肺泡巨噬细胞(AM)数和中性粒细胞(Neu)数较正常对照组显著增高(P<0.01);COPD各组血白细胞总数和中性粒细胞百分比(Neu%)与正常对照组之间均无统计学差异;COPD各组诱导痰IL-6水平均较正常对照组显著增高(P<0.01),血清IL-6水平仅COPDIII级、IV级较正常对照组有显著增高(P<0.05),COPD患者诱导痰上清液IL-6浓度显著高于自身血清IL-6浓度(P<0.01);COPDII级、III级和IV级诱导痰CRP浓度较正常对照组显著增高(P<0.01),COPDIII级和IV级血清CRP浓度较正常对照组显著增高(P<0.01),COPD患者血清CRP浓度显著高于自身诱导痰CRP浓度(P<0.01);痰和血IL-6、CRP浓度与痰细胞总数、痰Neu%呈正相关。结论AM、Neu、IL-6和CRP参与了稳定期COPD气道慢性炎症过程;重度气流受限的稳定期COPD患者体内可能存在系统性炎症反应。
[Objective] To investigate inflammatory cell in medium from sputum and blood in COPD patients. [Methods] 54 patients with stable COPD and 10 age-matched healthy controls were enrolled in the study. Collect their sputum and surum speciments at the same period, make blood routine examination. Cell numbers and differentials in sputum suspension were counted with wright＇s stain, The concentrations of sputum IL-6 and serum IL-6 were measured by ELISA. Suspension CRP and serum CRP were measured by transmissive heterometric titration. [Results] The total sputum cells and the numbers of Neu, AM in all stages of COPD patients were higher than those in controls （P 〈0.01）. There is no statistical difference in the number of white blood cell. Sputum IL-6 levels in all stages COPD patients were higher than those in controls （P 〈0.01）. Serum IL-6 levels in stage Ⅲ and stage Ⅳ COPD patients were higher than those in controls （P 〈0.05）. Sputum IL-6 levels were higher than serum IL-6 levels in COPD patients （P 〈0.01）. Sputum CRP levels in stage Ⅱ, Ⅲ,Ⅳ COPD patients were higher than those in controls （P 〈0.01）. Serum CRP levels in stage Ⅲ,Ⅳ COPD patients were higher than those in controls （P 〈0.01）. Serum CRP levels were higher than sputum CRP levels in COPD patients （P 〈0.01）. Sputum or serum IL-6 and CRP levels were positively correlated with the number of sputum cells and Neu%. [Conclusion] AM, Neu, IL-6, CRP may be involved in the airway inflammatory process in stable COPD. Systemic inflammatory process may be present in stable COPD patients with severe airflow obstruction.
出处
《中国现代医学杂志》
CAS
CSCD
北大核心
2006年第11期1725-1728,共4页
China Journal of Modern Medicine
