Study On The Correlation Between Serum IL-6 Level And Clinical Features Of Chronic Obstructive Pulmonary Disease

Chronic obstructive pulmonary disease(COPD),a common and frequently-occurring disease of the respiratory system,is a chronic inflammatory disease that can be prevented and treated.Its clinical features are persistent obstructed airflow and respiratory symptoms,usually associated with airway and/or pulmonary alveoli abnormalities caused by significant exposure to harmful particulate matter or gases.According to estimates from WHO,COPD is set to become the third leading cause of death worldwide by 2030.AECOPD refers to the acute exacerbation of respiratory symptoms in patients with COPD,including increased dyspnea,increased sputum,worsening cough,which require additional treatment for improvement.Interleukin-6 or IL-6,a cytokine with many biological activities,is essential to many diseases of different systems.Part One The Correlation between Serum IL-6 level and Clinical Features in Acute Exacerbation of Chronic Obstructive Pulmonary DiseasePurpose:To explore the correlation between serum IL-6 and clinical features of patients with AECOPD,thereby providing theoretical basis for the application of serum IL-6 in patients with AECOPD.Method:Retrospective collection from January 2016 to December 2017,150 patients with AECOPD were hospitalized in the Second People’s Hospital of Lianyungang.The general information of these patients was obtained by inquiring about their medical history,including medical history,gender,age,height,weight and so on.The serum IL-6,NT-proBNP,CRP,blood routine,blood gas analysis and cardiac colour ultrasonic diagnosis of the patients were measured.According to the Chinese Expert Consensus on the Diagnosis and Treatment of Acute Exacerbation of Chronic Obstructive Pulmonary Disease(AECOPD)(2017 updated version),the patients with AECOPD were divided into three grades,including 91 grade Ⅰ,48 grade Ⅱ and 11 grade Ⅲ.Based on the fact if the glucocorticoids should be used after admission,the patients were divided into hormone group and non-hormone group,including 76 cases in hormone group and 74 cases in non-hormone group.The serum IL-6 levels among different clinical grades were compared.The correlation between serum IL-6 and CRP,blood gas analysis,cardiac colour ultrasonic diagnosis,NT-proBNP and average hospitalization days was observed,concurrently with the observation of the effect of hormones on IL-6.Result:The serum IL-6 level of patients with AECOPD increased significantly with the severity of the disease.The correlation analysis suggested that the serum IL-6 of patients with AECOPD was positively correlated with CRP(P=0.000、r=0.621),moderately positively correlated with partial pressure of carbon dioxide(P=0.000、r=0.758)and pulmonary artery(P=0.000、r=0.834),and weakly positively correlated with right ventricular internal diameter(P=0.000、r=0.221)and NT-proBNP(P=0.000、r=0.272).The average length of hospitalization increased commensurately with the serum IL-6 level.Hormone therapy could cause the inhibition of the production of IL-6.Conclusion:The serum IL-6 level can be used to assess the severity of AECOPD.IL-6 is significantly correlated with inflammation in AECOPD.The serum IL-6 level in patients with AECOPD has certain guiding significance in predicting average hospitalization days.Hormone therapy can cause the inhibition of the production of IL-6.Part Two The Correlation between Serum IL-6 level and Clinical Features inStable Stage of Chronic Obstructive Pulmonary DiseasePurpose:To explore the correlation between serum IL-6 and clinical features of patients with stable stage of COPD,thereby providing theoretical basis for the application of serum IL-6 in patients with stable stage of COPD.Method:In the first part,150 patients with COPD in the study came back to the hospital for a check in one month after their leaving hospital.Among them,23 cases suffered from defulvium and 127 cases were detected for the relevant indicators.The correlation between serum IL-6 and NT-proBNP,CRP,blood routine,blood gas analysis,cardiac colour ultrasonic diagnosis,pulmonary function and CAT score was analyzed.Telephone follow-up was conducted one year after the patients leaving hospital to observe whether they had an acute attack again in one year,and to analyze the risk factors.Result:The serum IL-6 level of patients with stable COPD was moderately positively correlated with CAT score(P=0.000、r=0.648),CRP(P=0.000、r=0.621),partial pressure of carbon dioxide(P=0.000、r=0.758),pulmonary artery pressure(P=0.000、r=0.661),NTproBNP level(P=0.000、r=0.501),it was weakly positively correlated with RV(P=0.000、r=0.417),and weakly negatively correlated with partial pressure of oxygen(P=0.000、r=0.362)and FEV1%pred(P=0.000、r=-0.363).The serum IL-6,CAT score,pulmonary artery pressure and FEV1%pred of patients with stable COPD might be correlated with acute exacerbation within 1 year after their leaving hospital,with the serum IL-6 having the strongest correlation.Conclusion:The clinical symptoms of the patients with stable COPD will be more serious commensurately with the serum IL-6 level.IL-6 is essential to the inflammation of patients with stable COPD,and is related to their poor pulmonary function,right ventricular function and blood gas analysis.The serum IL-6 level can be used as a sensitive risk index for patients with AECOPD.