Study Of Evaluation And Application Of Impulse Oscillometry Pulmonary Function And Expression Of Toll Like Receptor2, 4 In Monocytes From Chronic Obstructive Pulmonary Disease

Background It is important to diagnose COPD and find flow limitation in early stage.Now conventional pulmonary function test is limited in patients with flow limitation and mismatched.Thus we need to find out a sensitive and convenient method.Deficiency of innate immune in COPD patients plays a role in chronic airway imflammation and systemic inflammation response.Learning about immune mechnism could provide a therapy for new anti-inflammation of COPD.Objective To investigate the clinical value of impulse oscillometry and the expression of TLR2,TLR4 in peripheral blood monocytes from COPD,through which we aim to find the best evaluation criteria and provide theoretical basis of immune mechanism.Methods To select 84 cases patients which were diagonoised as COPD in the department of respiration the second clinical hospital of Shanxi medical university, these patients were divided into mild 11 cases,moderate 23 cases,severe 30 cases and very severe 20 cases.There were 52 cases in stable period and 32 cases during acute period.All selected people were measured by conventional pulmonary function test, impulse oscillometry pulmonary function and collected 2ml venous blood.Flow cytometry were used to analyze relative mean fluorescence intensity(rMFI) of TLR2,TLR4 for peripheral blood monocytes.Results 1.Compared with the control group, there was a significant decrease in FEV1,FVC,FEV1/FVC,FEV1/pre in COPD groups(P<0.05);2.The IOS indices including Z5,R5,R20,R5-R20,Fres,Rc,Rp increased significantly in COPD groups compared control group(P<0.05), and Fres,Rp,R5-R20 in severe and very severe cases rise obviously compared to mild, moderate cases,which weren't positively correlated with severity of the COPD.X5 decreased significantly in COPD groups compared with the control group(P<0.05), and lower in severe and very severe cases compared to mild cases and moderate cases,but it wasn't worse with development of the disease.3. Z5,R5,R5-R20,Fres,Rp were neglatively correlated with FVC,FEV1,FEV1/FVC,FEV1/pre,X5 was positively correlated(P<0.05),the closest correlation was found in Fres with the severity of the COPD.4.The positive rate of diagnosis in Z5,R5,R5-R20/pre,X5,Fresincreased with the development of COPD,but Rp was reversed.R20 wasn't found anything. Fres was found to be the highest positivity with the severity of the COPD.5.The expression of TLR2 was up-regulated in peripheral blood monocytes from COPD patients,either clinically stable or acute period,as compared with the control group(P<0.05).Also,the expression of TLR2 during AECOPD increased significantly compared to the stable COPD(P<0.05).In contrast,the expressions of TLR4 was not significantly different between COPD groups,but decreased compared to the control group.6.The expression of TLR2 was neglatively in accordance with FEV1 and positively correlated with R5-R20.Conclusions (1)IOS can reflect completely the characteristics of respiratory physiological dynamics and is sensitive index to confirm the presence of airflow limitation and evaluate severity of chronic obstructive disease.(2)There are good elativity between IOS and cPFT as well as TLR2,which is the good criteria to monitor the condition of COPD.