慢性阻塞性肺疾病合并肺高压患者血清及呼出气冷凝液中炎症因子变化及意义
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南通市科技计划项目(HS2011038)


Changes and implications of inflammatory mediators in serum and exhaled breath condensate in patients with pulmonary hypertension associated with COPD
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    摘要:

    目的:通过检测慢性阻塞性肺疾病(chronic obstructive pulmonary disease,COPD)伴和不伴肺高压(pulmonary hyptertension,PH)患者血清及呼出气冷凝液(exhaled breath condensate,EBC)中高敏C-反应蛋白(hypersensitive C-reactive protein,hs-CRP)及白介素(interleukin,IL)-6等炎症因子的水平,探讨全身及肺部局部炎症反应与COPD继发PH的关系。方法:收集COPD合并PH患者(37例)-单纯COPD患者(48例)的血清及EBC标本,并常规行肺功能-动脉血气分析及超声心动图检查,ELISA方法检测血清及EBC中IL-6水平,采用乳胶增强透射免疫比浊法检测血清及EBC中hs-CRP水平。结果:①COPD合并PH组血清hs-CRP浓度为(17.16 ± 6.25)mg/L,IL-6浓度为(79.67 ± 18.72)ng/L,均明显高于单纯COPD组的hs-CRP(12.32 ± 7.91)mg/L和IL-6 (47.38 ± 14.94) ng/L(P均< 0.05);②COPD合并PH组EBC中hs-CRP浓度为(2.03 ± 0.46)mg/L,IL-6浓度为(8.75 ± 2.03)ng/L,均明显高于单纯COPD组的hs-CRP(1.72 ± 0.65)mg/L和IL-6(5.42 ± 1.58)ng/L(P 均< 0.05);③COPD合并PH组血清及EBC中hs-CRP及IL-6水平均与肺动脉压呈正相关(r为0.415~0.875,P均< 0.001)。结论:全身及肺脏局部炎症反应可能参与了COPD继发的PH形成过程。

    Abstract:

    Objective:To estimate the relationship between inflammation and pulmonary hypertension in patients with chronic obstructive pulmonary disease,we investigate the levels of C-reactive protein (CRP)and interleukin-6 (IL-6)in serum and exhaled breath condensate (EBC)in chronic obstructive pulmonary disease (COPD)with or without pulmonary hypertension. Methods:EBC and serum of 37 cases in PH associated with COPD and 48 cases in single COPD were collected. Lung function,arterial blood gases and echocardiography were assayed in all cases. ELISA was used for detecting the levels of IL-6 in EBC and serum. Particle-enhanced turbidimetric immunoassay was used for analyses the levels of hs-CRP in EBC and serum. Results: ①The levels of CRP[(17.16 ± 6.25)mg/L]and IL-6[(79.67 ± 18.72)ng/L]in serum in patients with pulmonary hypertension were significantly higher than those in patients without pulmonary hypertension (P < 0.001). ②The levels of CRP[(2.03 ± 0.46)mg/L mg/L]and IL-6[(8.75 ± 2.03)ng/L]in EBC in patients with pulmonary hypertension were significantly higher than those in patients without pulmonary hypertension (P < 0.05). ③PASP in the PH group was positively correlated with the levels of CRP and IL-6 both in serum and EBC(r = 0.415~0.875,P < 0.001). Conclusion: The inflammation reaction of system and local respirary tracts plays an important role in the pathogenisis of pulmonary hypertension in COPD.

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马 航,何海艳,邱海艳,陶一江.慢性阻塞性肺疾病合并肺高压患者血清及呼出气冷凝液中炎症因子变化及意义[J].南京医科大学学报(自然科学版),2013,(1):97-101

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  • 收稿日期:2012-10-14
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  • 在线发布日期: 2013-03-25
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