慢性阻塞性肺病患者血清IL-21、IL-6、IL-17的水平及意義
[Abstract]:Objective: To investigate the expression of IL-21, IL-17, IL-6 and ROR-gamma t in serum of patients with chronic obstructive pulmonary disease (COPD) at acute exacerbation stage and stable stage, and the relationship between IL-21-ROR-gamma t-IL-21, IL-17 inflammatory response axis, IL-6/IL-21 pulmonary artery axis and COPD. Methods: From September 2015 to September 2016, 120 patients with COPD were selected from the Department of Respiratory Medicine, Qingdao University Affiliated Hospital. Among them, 60 patients in acute exacerbation stage were treated as acute stage group and 60 patients in stable stage were treated as stable stage. All the patients got up in the morning and measured the levels of IL-21, IL-17, IL-6 and ROR gamma t by ELISA. The indexes of FEV1, FVC, FEV1/FVC, pulmonary artery diameter, pulmonary artery pressure and right ventricular diameter were also measured. Results: 1. The serum levels of IL-21, IL-17, IL-6 and ROR gamma t in the acute exacerbation group were 279.107 (+ 17.836) pg/ml, 224.109 (+ 30.051) pg/ml in the stable phase group and 170.201 (+ 25.197) pg/ml in the control group. The levels of IL-21, IL-17, IL-6 and ROR gamma t in the acute exacerbation group were higher than those in the stable phase group and the healthy control group (t = 11.8, 26.63, P 0.05). The level of serum IL-17 in acute exacerbation group was 145.114 (+19.961) pg/ml, stable phase group was 49.830 (+7.735) pg/ml, control group was 25.819 (+4.376) pg/ml, acute phase group was significantly higher than stable phase group, healthy control group (t = 33.34, 44.07, P 0.05), stable phase group was significantly higher than control group (t = 20.35, P 0.0.05). The serum levels of IL-6 in acute exacerbation group were 39.414+3.225 pg/ml, 32.598+3.475 pg/ml in stable phase group, 24.831+2.121 pg/ml in control group, significantly higher in acute phase group than in stable phase group, healthy control group (t = 10.81, 28.52, P 0.05), stable phase group was higher than that in control group (t = 14.31, P 0.05). 206 + 0.263 ng / ml, 2.527 + 0.469 ng / ml in stable phase group, 2.095 + 0.271 ng / ml in control group, significantly higher in acute phase group than in stable phase group (t = 8.33, 18.4, P 0.05). Respiratory function of stable phase group was significantly higher than that of control group (t = 2.69, P 0.05). 2. Respiratory function of three groups in FEV1, FEV1 / FVC was lower in acute exacerbation phase than that of stable phase group and healthy control group. The levels of serum C-reactive protein, erythrocyte sedimentation rate and D-dimer in acute exacerbation were significantly higher than those in stable and healthy control groups (P 0.05). There was no significant difference in ESR among the three groups. D-dimer in acute exacerbation was higher than that in stable and normal period. The difference was statistically significant (P 0.05). 4. The pulmonary artery diameter in the stable phase was higher than that in the healthy control group (P 0.05). The pulmonary artery pressure in the stable phase was higher than that in the stable phase (P 0.05). The pulmonary artery pressure in the stable phase was higher than that in the healthy control group (P Stable phase was higher than normal phase (P 0.05). 5. The expression of IL-21 in COPD patients with pulmonary hypertension and COPD patients without pulmonary hypertension was 273.26 (+ 23.45) pg/ml in acute exacerbation, 230.88 (+ 39.02) pg/ml in stable phase and 170.2 pg/ml in healthy control group. The results of IL-6 assay showed that the acute exacerbation stage was 37.32+4.76pg/ml, the stable stage was 34.48+4.79 pg/ml, the healthy control group was 24.73+2.13 pg/ml, the expressions of IL-21 and IL-6 in the acute exacerbation stage were significantly higher than those in the stable stage and healthy control group, and the expression of IL-6 in the stable stage was higher than that in the healthy control group (P 0.05). The mean internal diameter of pulmonary artery in the acute exacerbation stage was 26.61 (+ 2.59 mm), the stable stage was 25.51 (+ 2.34 mm) and the healthy control group was 23.72 (+ 1.89 mm). There were significant differences between the acute exacerbation stage and the stable stage and the healthy control group. Correlation analysis showed that serum IL-21 was positively correlated with IL-17, IL-6 and ROR gamma t (r = 0.795, 0.775, 0.686, P 0.05), and positively correlated with CRP (r = 0.611, P 0.05); negatively correlated with FEV1 / FVC, FEV1 (r = - 0.729, - 0.830, P 0.05); positively correlated with mean diameter of pulmonary artery and pulmonary artery pressure (r = 0.448, 0.802, P 0.05). Conclusion: 1. The expression of serum IL-21 in COPD patients was significantly increased, especially in acute exacerbation of COPD. IL-6, IL-17 and ROR-gamma T were positively correlated, suggesting that IL-21 was involved in the airway inflammation of COPD. IL-21 may play an important role in the progression of COPD through the IL-21-ROR-gamma t (TH17) -IL-17 axis. Interleukin-21 participated in the inflammatory process of COPD and played a role in promoting inflammation and bridging. 2. IL-21 was negatively correlated with airflow limitation index FEV1 / FVC, and negatively correlated with disease severity index FEV1, suggesting that IL-21 participated in the process of airflow limitation, with the increase of IL-21 expression, the disease gradually aggravated.3. COPD. The expression of IL-21 and IL-6 was significantly correlated with IL-6, mean pulmonary artery diameter and pulmonary artery pressure, suggesting that IL-21 participated in the process of pulmonary artery changes and pulmonary hypertension formation through the IL-6/IL-21 pulmonary vascular pathway.
【學(xué)位授予單位】:青島大學(xué)
【學(xué)位級別】:碩士
【學(xué)位授予年份】:2017
【分類號】:R563.9
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