摘要
目的通过检测血清C反应蛋白（CRP）、白介素（IL）-6及肿瘤坏死因子（TNF）-α等炎性因子的水平,观察全身炎症反应与慢性阻塞性肺疾病（COPD）继发肺动脉高压的关系。方法淮安市第一人民医院呼吸科2008年1月~2012年2月收治的89例COPD患者,其中男63例,女26例,平均年龄（68±11）岁,平均FEV1占预测值百分比为（43±16）%。心脏超声测定肺动脉压;行痰检测,酶联免疫吸附法测定血清IL-1、TNF-α和CRP水平。结果 89例中49例伴肺动脉高压为A组;40例不伴肺动脉高压为B组。A组血清CRP[中位78.4 mg/L（57.5~125.6）mg/L]和TNF-α[中位20.1 pg/mL（14.9~25.7）pg/mL]明显高于B组CRP[中位61.8 mg/L（41.3~82.2）mg/L]和TNF-α[中位12.2 pg/mL（8.9~18.9）pg/mL,但A组血清IL-6[中位14.3pg/mL（9.5~20.8）pg/mL]和B组IL-6[中位14.5 pg/L（10.5~19.2）pg/mL]无明显差异。多元线性回归分析结果显示,PaO2、血清CRP水平（均P〈0.05）是收缩期肺动脉压升高的独立预测因素。结论血清CRP和TNF-α水平的升高与COPD患者中肺动脉压升高相关,提示全身炎症可能参与了COPD继发肺动脉高压的形成。
【Objective】The levels of C-reactive protein（CRP）, tumor necrosis factor（TNF）-α and interleukin-1（IL-6）, were investigated to analyze the systemic inflammation in chronic obstructive pulmonary disease（COPD） patients with and without pulmonary hypertension. 【Methods】From January 2008 to February 2012, 89 patients with COPD were enrolled in our hospital. There were 63 males and 26 females, with a mean age of（68 ±11） and a mean FEV1 of（43±16）%. Pulmonary pressure was assessed by Doppler echocardiography. The levels of plasma CRP, TNF-αand IL-6 were measured by enzyme-linked immunosorbent assay kits.【Results】49 patients were classified as COPD with pulmonary hypertension group and 40 patients as COPD without pulmonary hypertension group. The level of CRP [median, 78.4 mg/L（57.5~125.6） mg/L] and TNF-α [median, 20.1 pg/mL（14.9~25.7） pg/mL] in patients with pulmonary hypertension were significantly higher than in that in patients without hypertension, CRP [median 61.8 mg/L（41.3 ~82.2） mg/L] and TNF-α[median, 12.2 pg/mL（8.9~18.9） pg/mL. But no differences were seen in serum IL-6 [[median, 14.3 pg/mL（9.5~20.8） pg/mL] vs IL-6 [median, 14.5 pg/L（10.5~19.2） pg/mL] between the groups. Multivariate analysis showed that PaO2（P 0.05） and CRP（P 0.05） could predict pulmonary hypertension independently. 【Conclusions】The level of CRP and TNF-α were related to pulmonary hypertension in COPD patients, suggesting that systemic inflammation play a role in the pathogenesis of pulmonary hypertension in COPD.
出处
《中国现代医学杂志》
CAS
CSCD
北大核心
2013年第33期27-31,共5页
China Journal of Modern Medicine
关键词
慢性阻塞性肺疾病
肺动脉高压
C反应蛋白质
肿瘤坏死因子Α
白介素6
chronic obstructive pulmonary disease
pulmonary hypertension
C-reactive protein
interleukin-6
tumor necrosis factor
