Correlation Analysis Between Inflammatory Cytokines And Pulmonary Function Phenotype In Acute Exacerbation Of COPD

Objective COPD is a heterogeneous disease,the pathological physiology,imaging changes,clinical manifestations,disease progression,response to treatment and prognosis are very different between different COPD patients.COPD can be divided into a variety of phenotypes related to susceptibility factors,respiratory physiology,clinical manifestations,imaging and complications,they can respond well to the differences in disease characteristics and severity,and pulmonary function phenotype and systemic inflammatory response phenotype are important COPD-related phenotypes.Although lung function is currently the main indicator to assess the severity of COPD,it cannot fully reflect the heterogeneity of COPD.Therefore,the discussion of the correlation between various phenotypes is of great significance for guiding the specific treatment of phenotypes and determining the prognosis.Inflammatory mechanism and autoimmune mechanism are related to the occurrence and development of COPD.The abnormal expression of multiple inflammatory mediators such as IL-6,hs-CRP and the infiltration of inflammatory cells play important roles in the occurrence and development of COPD airway inflammation and systemic inflammation.It was found that there were T lymphocyte infiltrations in the airway,lung parenchyma and pulmonary vessels in COPD patients,the immune function of patients with chronic obstructive pulmonary disease is disordered.Pulmonary function in chronic obstructive pulmonary disease continues to deteriorate irreversibly,seriously affecting the quality of life of patients,the COPD assessment test?CAT?is an important tool to assess the quality of life and severity of CODP patients,which is widely used in western countries,but there are few comprehensive analyses on CAT score,inflammation and immunity.At present,the relationship between systemic inflammatory responses and autoimmune disorders of COPD and the severity and clinical manifestations of COPD has not been fully defined,so we study the changes of hs-CRP,IL-6 and T lymphocyte subsets in patients with different grades of acute exacerbation of COPD and their correlation with CAT score and lung function to explore the application value of the above indicators in the assessment of acute exacerbation of COPD.Methods Collecting 90 hospitalized patients with acute COPD exacerbation of the department of respiratory medicine of Chaohu Hospital of Anhui Medical University in September 2017-April 2018,among which 66 were male,female 24 cases,aged52-87?72.5±7.7?,all of them met the diagnostic criteria and staging definition of the guidelines for the diagnosis and treatment of chronic obstructive pulmonary disease?COPD?revised by the Chinese society of respiratory medicine in 2013.Exclusion criteria:?1?combined with asthma,tuberculosis,bronchiectasis,pulmonary interstitial fibrosis and other chronic lung diseases;?2?severe heart,liver and kidney diseases;?3?malignant tumors;?4?autoimmune diseases;?5?extrapulmonary infectious diseases;?6?patients who have received systemic hormone therapy within a month?oral or intravenous therapy?.Patients are divided into four grades according to the GOLD grade,20 cases in?class,25 cases in?class,25 cases in?class,20 cases in?class.Collecting the venous blood of the elbow was collected on the fasting state the next day after admission,detecting serum hs-CRP by immunoturbidimetry,detecting IL-6 by upturn luminescence,detecting T lymphocyte subsets by flow cytometry,including CD₃⁺%,CD₄⁺%,CD₈⁺%,CD₄⁺/CD₈⁺,and pulmonary function examination and CAT score were performed.The differences of serum hs-CRP,IL-6 and lymphocyte subsets among different GOLD grades and their correlation with CAT score and lung function indexes were analyzed.Results The levels of serum hs-CRP,IL-6 and CAT scores increased with lung function grading?P<0.05?,and CD₄⁺%and CD₄⁺/CD₈⁺decreased with lung function grading?P<0.05?.The levels of serum hs-CRP and IL-6 were negatively correlated with CD₄⁺%,CD₄⁺/CD₈⁺,FEV₁,FEV₁%pred and FEV₁/FVC?P<0.01?;CD₄⁺%and CD₄⁺/CD₈⁺were positively correlated with FEV₁,FEV₁%pred and FEV₁/FVC?P<0.01?;CAT scores were positively correlated with hs-CRP and IL-6?P<0.01?,and negatively correlated with CD₄⁺%,CD₄⁺/CD₈⁺,FEV₁,FEV₁%pred and FEV₁/FVC?P<0.01?.Conclusion Serum hs-CRP,IL-6,T-lymphocyte subsets levels and CAT scores are closely related to the severity of the acute exacerbation of COPD,and can be used as good indexes to evaluate the severity of the acute exacerbation of COPD.