The Changes Of IL-6, IL-32and INF-γ Of Serum In Chronic Obstructive Pulmonary Disease And The Relationship With The Bode Index

ObjectiveThis study focused on the changes of serum cytokine IL-6, IL-32and INF-y after the treatment with budesonide inhalation of acute exacerbations of chronic obstructive pulmonary disease(COPD). The three cytokines in patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD) could be explored the dependablity pathophysiology of COPD. We discussed the correlations of the three cytokines and BODE index separately. Instead of BODE index, the three cytokines could provide theoretical evidence for reasonable diagnosis and appraise treatment prognosis in COPD patients.Methods1. Object1.1AECOPD group:31patients of COPD in our hospital were enrolled in the study.The inclusion standard was such as below:patients diagnosed COPD according to the GOLD published in2011; without hormone therapy before admission (excluding infusion therapy and using composition unknown drugs extrahospital); excluding the diseases which combined effects of endocrine and cytokine changes such as malignant tumor, active tuberculosis, severe illness; excluding others who cannot complete pulmonary function tests.1.2The stable group:AECOPD patients after1months follow-up of the stabilization period were selected, a total of31cases, and cough, sputum, wheezing and other symptoms were stable or disappeared more than1month.1.3Healthy control group:we selected35healthy people which matched AECOPD group on sex and age as the control group and screened according to the systemic health check list, ruled out the diseases of heart, brain, lung, kidney after history taking, physical examination, and laboratory examinations, excluded systemic infection history nearly two months.2. Treatment methodAccording to the condition and inspection results, the patients were given routine drug therapy without hormone.After finishing the blood specimen collection at the2nd day, The patients who were chosen were given budesonide atomization. Atomizing15minutes and twice a day, after the7days treatment, taking the blood samples in the morning on the8th day, and reviewing the lung function to evaluate its clinical efficacy.3. Serum cytokines IL-6、 IL-32、 INF-γ measurementsAll enrolled would be taken cubits venous blood6ml into a dry test tube. We separated serum through centrifuge15minutes with a speed of3000rm/in, put the remaining serum into the icebox at-70℃. We measured the levels of IL-32and INF-γ by enzyme-linked immuno sorbent assay and detected the levels of IL-6by electroluminescence.4. BODE index measurementAll enrolled would be finished the BODE index assessment at pre-treatment, after treatment and follow-up separately. We measured them with the same instrument. The form is followed in the appendix1. They were finished by myself.5. Statistics Data were presented as means±SD by SPSS19.0statistical analysis package, and the correlation in the groups variance analysis, with ap≤0.05designated as significant differences.Using rectilinear correlation to determine wether they were correlated.Results(1) IL-6in blood serumThe serum IL-6of the four groups were statistically significant (F=222.249, P<0.01).The level of IL-6in serum of AECOPD group pre-treatment were more than after treatment, follow-up group and the healthy control group(P<0.01; P<0.01;P<0.01respectively).Therefore, IL-6in serum of after treatment group were more than follow-up group and the control group(P<0.01;P<0.01respectively). Compared with control group,the level of IL-6in follow-up group was increased, but without significant difference(P>0.05). By the analysis of linear correlation, in AECOPD group, BODE index was respectively positively correlated with pre-treatment serum IL-6(r=0.916, P<0.01), after treatment (r=0.815, P<0.01), stable group (r=0.744, P<0.01) and even more positively correlated with IL-6in all groups(r=0.753,P<0.01).(2) IL-32in blood serumThe serum IL-32of the four groups were statistically significant.(F=555.938, P<0.01). The level of IL-32in serum of AECOPD group pre-treatment were more than after treatment, follow-up group and the healthy control group respectively(P<0.01; P<0.01;P<0.01respectively). Therefore, IL-32in serum of after treatment group were more than follow-up group and the control group(P<0.01;P<0.01respectively). Compared with control group,the level of IL-32in follow-up group was increased, and with significant difference(P<0.01). By the analysis of linear correlation, in AECOPD group, BODE index was respectively positively correlated with pre-treatment serum IL-32(r=0.896, P<0.01), after treatment (r=0.818, P <0.01), stable group (r=0.822, P<0.01) and even more positively correlated with IL-32in all groups(r=0.817, P<0.01).(3) INF-γ in blood serumThe serum INF-y of the four groups are statistically significant (F=64.033, P<0.01). The level of INF-y in serum of AECOPD group pre-treatment were more than after treatment, follow-up group and the healthy control group respectively(P<0.01;/P<0.01;P<0.01respectively). Therefore, INF-y in serum of after treatment group were more than follow-up group and the control group(P<0.01;P<0.01respectively). Compared with control group,the level of INF-y in follow-up group was increased, and with significant difference(P<0.01). By the analysis of linear correlation, in AECOPD group, BODE index was respectively positively correlated with pre-treatment serum INF-y (r=0.788, P<0.01), after treatment (r=0.589, P <0.01), stable group (r=0.790, P<0.01)and even more positively correlated with INF-y in all groups(r=0.772, P<0.01).(4) BODE indexThe BODE index of the four groups are statistically significant (F=30.049, P<0.01). The level of BODE index of AECOPD group pre-treatment were more than after treatment, follow-up group and the healthy control group respectively(P<0.01;P<0.01;P<0.01respectively). Therefore, the BODE index of after treatment group were more than follow-up group and the control group(P<0.01;P<0.01respectively). Compared with control group,the level of the BODE index in follow-up group was increased, and with significant difference(P<0.01).Conclusion1. The levels of IL-6, IL-32and INF-γ in blood serum were concerned with the severity of COPD. With the stable of COPD, the three cytokines were all decreased.2. The levels of IL-6, IL-32and INF-y in AECOPD were correlated to BODE index of COPD patients. They could reflect the severity of COPD. The three cytokines all could be used to cinical practice and they had higher clinical valuation in assistant diagnose, treatment and prognosis assessment.