Morales S Arturo, Dreyse D Jorge, Díaz P Orlando, Saldías P Fernando, Carrasco Marcela, Lisboa B Carmen
Servicio de Medicina, Hospital San Juan de Dios, Chile.
Rev Med Chil. 2010 Aug;138(8):957-64. Epub 2010 Nov 26.
Low grade systemic inflammation is commonly observed in chronic obstructive pulmonary disease (COPD).
To evaluate the extent of systemic inflammation in a group of ex-smokers with COPD in stable condition and its relation with pulmonary function and clinical manifestations.
We studied 104 ex-smokers aged 69 ± 8 years (62 males) with mild to very severe COPD and 52 healthy non-smoker subjects aged 66 ± 11 years (13 males) as control group. High sensitivity serum C reactive protein (CRP), interleukin 6 (IL6), fibrinogen (F) and neutrophil count (Nc) were measured. Forced expiratory volume in the first minute (FEV1), inspiratory capacity (IC), arterial blood gases, six minutes walking test, dyspnea and body mass index (BMI) were measured, calculating the BODE index. Health status was assessed using the Saint George Respiratory Questionnaire (SGRQ), the chronic respiratory questionnaire (CRQ), registering the number of acute exacerbations (AE) during the previous year and inhaled steroids use. Systemic inflammation was considered present when levels of CRP or IL6 were above the percentile 95 of controls (7.98 mg/L and 3.42 pg/ml, respectively).
COPD patients had significantly higher CRP and IL6 levels than controls. Their F and Nc levels were within normal limits. Systemic inflammation was present in 56 patients, which had similar disease severity and frequency of inhaled steroid use, compared with patients without inflammation. Patients with systemic inflammation had more AE in the previous year; lower inspiratory capacity, greater dyspnea during the six minutes walk test and worse SGRQ and CRQ scores.
Low-grade systemic inflammation was found in 56 of 104 ex-smokers with COPD. This group showed a greater degree of lung hyperinflation, dyspnea on exercise and poor quality of life.
慢性阻塞性肺疾病（COPD）患者中普遍存在低度全身炎症。
评估一组病情稳定的COPD戒烟者的全身炎症程度及其与肺功能和临床表现的关系。
我们研究了104名年龄为69±8岁（62名男性）的轻度至重度COPD戒烟者以及52名年龄为66±11岁（13名男性）的健康非吸烟受试者作为对照组。测量了高敏血清C反应蛋白（CRP）、白细胞介素6（IL6）、纤维蛋白原（F）和中性粒细胞计数（Nc）。测量了第1分钟用力呼气量（FEV1）、吸气容量（IC）、动脉血气、6分钟步行试验、呼吸困难和体重指数（BMI），计算BODE指数。使用圣乔治呼吸问卷（SGRQ）、慢性呼吸问卷（CRQ）评估健康状况，记录前一年的急性加重次数（AE）和吸入类固醇的使用情况。当CRP或IL6水平高于对照组第95百分位数（分别为7.98mg/L和3.42pg/ml）时，认为存在全身炎症。
COPD患者的CRP和IL6水平显著高于对照组。他们的F和Nc水平在正常范围内。56名患者存在全身炎症，与无炎症患者相比，其疾病严重程度和吸入类固醇的使用频率相似。有全身炎症的患者前一年的AE更多；吸气容量更低，6分钟步行试验时呼吸困难更严重，SGRQ和CRQ评分更差。
104名COPD戒烟者中有56名存在低度全身炎症。该组患者表现出更严重的肺过度充气、运动性呼吸困难和生活质量差。
