| Objective Chronic obstructive pulmonary disease(COPD)is a chronic lung disease characterized by incomplete reversible and chronic progressive persistent airflow limitation.It has been proved that a variety of inflammatory mediators(such as IL-6,IL-17,TNF-a,IL-8,CRP,etc.)have a certain guiding significance in judging the condition of patients with COPD,but these indicators do not reflect the value of recurrence risk in patients with COPD.IL-38 is rarely expressed in tonsil,skin,heart and lung tissues of healthy people,but it is used as an inflammatory mediator.It has been proved that it is highly expressed in a variety of chronic inflammatory diseases and some acute inflammatory diseases,and is related to the severity and activity of the disease.Previous studies have confirmed that IL-38 is involved in the course of COPD,but its role in acute exacerbation of risk remains to be clarified.In this study,the expression level of IL-38 in peripheral blood was detected and grouped according to GOLD guidelines to explore its correlation with clinical data and clinical value.Methods A total of 76 patients with AECOPD hospitalized in Chaohu Hospital affiliated to Anhui Medical University from January 2019 to June 2020 were collected as acute addition and recombination(male 44,female 32,mean age 69.71 ±4.24 years,age range 60 78 years),and 76 stable COPD patients were selected as stable group(40males,36 females,mean age 68.39 ±5.10 years,age range 55 78 years).The control group was selected from 62 healthy subjects(male 34,female 28,mean age 68.81±4.73 years old,age range 5578 years old).According to GOLD guidelines,patients with acute addition and recombination were divided into groups A,B,C and D.although this group was the most common,it was not consistent with the characteristics of COPD population in China.According to this study,patients with acute addition and recombination were divided into AB group(age range: 60-75 years old,17 males and 16females).The average age was 68.76 ±4.01 years old,and the CD group(age range:60-78 years old,27 males,16 females,mean age 70.30 ± 4.31 years).In order to further explore the value of peripheral blood IL-38 in the risk of acute exacerbation,according to the DOSE score,the patients were divided into high risk group(≥ 4)and low risk group(n = 21).The higher the score,the more severe the patients’ recurrent risk and symptoms.Therefore,according to the DOSE score,the patients with acute exacerbation were divided into high risk group(23 males,10 females,mean age 69.44±4.38 years,age range 60 78 years)and low risk group(21 males and 22 females).The average age was 70.15 ±4.08 years old,and the age range was 60-76 years old.All the patients in the group met the diagnostic criteria and staging definition of the guidelines for the diagnosis and treatment of chronic obstructive Pulmonary Disease revised by the Chinese Medical Association in 2019.Exclusion criteria:(1)suffering from diabetes and autoimmune diseases;(2)suffering from tumor,severe heart,liver and kidney diseases;(3)recent history of trauma and operation.Before treatment,the peripheral blood of patients was taken,and the content of IL-38 in peripheral blood was measured by double antibody immune sandwich method((ELISA)).Pulmonary function test and m MRC,CAT score were performed.The expression level of IL-38 in peripheral blood was detected and grouped according to GOLD guidelines to explore its correlation with clinical data and clinical value.Results The peripheral blood IL-38 level in acute plus recombinant group was higher than that in stable group and control group,and that in stable group was significantly higher than that in control group(P < 0.05.The peripheral blood IL-38 level in);CD group was significantly higher than that in AB group,and the level of IL-38 in high risk group was significantly higher than that in low risk group(P < 0.05).Correlation analysis showed that IL-38 in peripheral blood was positively correlated with IL-6,CRP,m MRC,the number of acute exacerbations in the past year and DOSE score(r = 0.412,0.377,0.233,0.330,0.247),and negatively correlated with the predicted value of FEV1%(r =-0.226).Multiple regression analysis showed that IL-6,CRP and the number of acute exacerbations in the past year were independent influencing factors of IL-38 in peripheral blood.Conclusion The expression of IL-38 in peripheral blood is increased in patients with acute exacerbation of chronic obstructive pulmonary disease,and is closely related to the level of inflammatory reaction in vivo,which can be used as an independent risk factor for acute exacerbation. |
PDF Full Text Request