【摘要】：研究背景 慢性阻塞性肺疾病(chronic obstructive pulmonary disease, COPD)是呼吸系統(tǒng)常見病、多發(fā)病,它是一種由于慢性支氣管炎和肺氣腫導(dǎo)致氣流受限為特征的可以預(yù)防和治療的肺部疾病,氣流受限不完全可逆,呈進(jìn)行性發(fā)展。研究認(rèn)為,COPD的發(fā)病與肺部對(duì)香煙、煙霧、廢氣等有害氣體或顆粒吸入所產(chǎn)生的異常炎癥有關(guān)。據(jù)統(tǒng)計(jì),2000年COPD占全球死亡原因的第4位,預(yù)計(jì)到2020年,COPD將上升為第3位致死原因,且成為全球經(jīng)濟(jì)負(fù)擔(dān)的第5位。近年來,慢性阻塞性肺疾病患病率逐年上升,且病死率高,嚴(yán)重影響患者的生活質(zhì)量及勞動(dòng)能力,增加家庭及社會(huì)的經(jīng)濟(jì)負(fù)擔(dān),已成為一個(gè)全球關(guān)注的重要公共衛(wèi)生問題。 COPD發(fā)病機(jī)制尚未完全闡明,病理表現(xiàn)多樣,目前可用于評(píng)估慢性阻塞性肺疾病(COPD)患者病情和臨床療效的標(biāo)志物有限。許多研究者指出在COPD發(fā)病過程中,炎癥反應(yīng)起關(guān)鍵作用,多種細(xì)胞因子、趨化因子、炎癥細(xì)胞、粘附分子參與了COPD的發(fā)生和發(fā)展。有些細(xì)胞因子、趨化因子等有可能成為臨床評(píng)估COPD嚴(yán)重程度的指標(biāo),在其發(fā)病過程中起重要作用。趨化因子配體-18(CCchemokine ligand-18, CCL-18)屬于CC族趨化因子,CCL-18mRNA在肺中持續(xù)高水平表達(dá),研究發(fā)現(xiàn)其很可能參與機(jī)體首次免疫應(yīng)答,但在COPD中的作用國內(nèi)還無人研究。白細(xì)胞介素-6(Interleukin-6, IL-6)屬于前炎癥因子,能促進(jìn)及加重局部炎癥反應(yīng)的發(fā)生發(fā)展,在COPD的發(fā)病中起重要作用。 因此,探尋CCL-18在COPD發(fā)展進(jìn)程中的作用,可以了解其在疾病進(jìn)程中的作用,以指導(dǎo)臨床治療。 目的 本研究通過測定慢性阻塞性肺疾病急性加重期患者治療前后血清中CCL-18、IL-6表達(dá)水平的變化,并以健康者作對(duì)照,測定其與患者肺功能相關(guān)性,以IL-6為參照,探討CCL-18在慢性阻塞性肺疾病患者治療過程中的臨床意義,為判斷患者病情嚴(yán)重程度及指導(dǎo)治療提供依據(jù)。 方法 選取2012年7月至2012年9月于鄭州大學(xué)第一附屬醫(yī)院住院的慢性阻塞性肺疾病急性加重期患者30例,并依據(jù)患者年齡、性別選取30例門診健康體檢者作對(duì)照組,分別于晨起空腹?fàn)顟B(tài)下抽取慢性阻塞性肺疾病急性加重期患者治療前、后及健康對(duì)照組靜脈血,離心后應(yīng)用酶聯(lián)免疫吸附法檢測各組血清中CCL-18、IL-6表達(dá)水平的變化,并評(píng)價(jià)其與患者肺功能的相關(guān)性。 結(jié)果 慢性阻塞性肺疾病急性加重期患者治療前、后血清中CCL-18、IL-6含量較健康者明顯升高,差異有統(tǒng)計(jì)學(xué)意義(P0.05)。慢性阻塞性肺疾病急性加重期患者治療后較治療前血清中CCL-18、IL-6含量明顯降低,差異有統(tǒng)計(jì)學(xué)意義(P0.05)。血清中CCL-18、IL-6含量與患者肺功能中FEVl占預(yù)計(jì)值百分比及FEV1/FVC數(shù)值呈負(fù)相關(guān)。CCL-18與IL-6的變化同步。 結(jié)論 CCL-18可能參與了慢性阻塞性肺疾病的炎性反應(yīng)過程。它的檢測對(duì)判斷慢性阻塞性肺疾病患者病情嚴(yán)重程度具有指導(dǎo)意義,可以作為判斷COPD患者病情的指標(biāo),從而指導(dǎo)臨床治療。
[Abstract]:Study Background Chronic obstructive pulmonary disease (COPD) is a common disease in the respiratory system. It is a kind of lung disease that can be prevented and treated due to the limited air flow caused by chronic bronchitis and emphysema. retrogression The study found that the incidence of COPD and the abnormal inflammation caused by the inhalation of harmful gas or particles such as cigarette, smoke, exhaust gas, etc. According to statistics, in 2000, COPD accounted for 4 of the cause of global death, and it is expected that in 2020, COPD will rise to the third fatal cause and be the fifth of the global economic burden. In recent years, the prevalence of chronic obstructive pulmonary disease has increased year by year, and the fatality rate is high, which seriously affects the quality of life and the labor capacity of the patients, increases the economic burden of the family and society, and has become an important public health question of global concern The pathogenesis of COPD is not yet fully set forth, and the pathological manifestations are diverse and can be used to assess the condition and clinical curative effect of patients with chronic obstructive pulmonary disease (COPD). Many researchers note that inflammatory response plays a key role in the pathogenesis of COPD, and various cytokines, chemokines, inflammatory cells, and adhesion molecules are involved in the occurrence of COPD And development. Some cytokines, chemokines, and the like can be used as an indicator for clinical assessment of the severity of COPD and can be lifted during the course of the disease. The chemokine ligand-18 (CCL-18) is a CC-family chemokine, and the CCLL-18 mRNA is expressed in the lung at a high level. It is found that it is likely to be involved in the first immune response of the body, but the role of the chemokine ligand-18 (CCLL-18) in COPD is not yet available. Human research. Interleukin-6 (Interleukin-6, IL-6) belongs to the pre-inflammatory factors, can promote and aggravate the development of local inflammatory reaction, and can be used for hoisting in the pathogenesis of COPD. It is important to explore the role of CCL-18 in the development of COPD and to understand its role in the process of disease and to refer to its role in the process of disease progression. guide Objective To study the changes of the expression of CCLL-18 and IL-6 in the serum of patients with acute exacerbation of chronic obstructive pulmonary disease. The clinical significance of CCL-18 in the treatment of patients with chronic obstructive pulmonary disease was discussed with the reference of IL-6. and the finger According to the method,30 patients with acute exacerbation of chronic obstructive pulmonary disease were selected from July 2012 to September 2012 in the first affiliated hospital of Zhengzhou University, and 3 cases were selected according to the age of the patient. The changes of the expression of CCLL-18 and IL-6 in the serum of 0 patients with acute exacerbation of chronic obstructive pulmonary disease were detected by enzyme-linked immunosorbent assay (ELISA), and the levels of the expression of CCLL-18 and IL-6 in each group were detected by enzyme-linked immunosorbent assay (ELISA). evaluation The results showed that the levels of CCLL-18 and IL-6 in the serum of patients with acute exacerbation of chronic obstructive pulmonary disease were higher than those in the healthy ones. The content of CCl-18 and IL-6 in the serum of patients with acute exacerbation of chronic obstructive pulmonary disease was significantly lower than that in the pre-treatment group. The difference was significant (P0.05). The contents of CCL-18, IL-6 in serum and FEV1 in the lung function of the patient were 100%. There was a negative correlation between the fractional ratio and the value of FEV1/ FVC. .C CL-18 is synchronized with the change in IL-6. Conclusion CCL-1 8. It may be involved in the inflammatory response of chronic obstructive pulmonary disease. Its detection is of guiding significance to the determination of the severity of chronic obstructive pulmonary disease. It can be used as a judgment.
【學(xué)位授予單位】：鄭州大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2013
【分類號(hào)】：R563

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