Feng Enzhi, Wan Ronghua, Yang Shengyue, Yan Ziqiang, Wang Shaolin, He Wei, Zhang Ying, Yin He, Chen Zongru, Liu Ruinian
Center of Respiratory Medicine, The Fourth Hospital of PLA, Lanzhou Command, Xining, Qinghai 810007, P.R. China.
Exp Ther Med. 2013 Sep;6(3):747-752. doi: 10.3892/etm.2013.1192. Epub 2013 Jul 1.
The aim of this study was to assess the expression levels of induced sputum interleukin (IL)-8 and IL-10 levels in patients with acute exacerbated chronic obstructive pulmonary disease (AECOPD) complicated with chronic cor pulmonale (CCP) at high altitude, and to evaluate the intervention effects of an inhaled corticosteroid (ICS) and a β-adrenoceptor agonist in this disease. A total of 186 patients with AECOPD complicated with CCP were randomly divided into three groups, with 62 cases in each. With regard to the two treatment groups, group A was treated with salmeterol/fluticasone (50 μg/250 μg, respectively) by airway inhalation twice daily, while group B received budesonide (1 mg) as a spray inhalation, twice daily. The routine treatment group (group C) received only routine treatment. The levels of IL-8 and IL-10 in the induced sputum and the predicted percentage of forced expiratory volume in one second (FEV), partial pressure of oxygen in arterial blood (PaO) and partial pressure of carbon dioxide in arterial blood (PaCO) were examined on admission and at a stable stage two weeks following treatment. Forty healthy volunteers served as a control group (group D). Compared with group D values, the IL-8 induced sputum level and the PaCO were significantly increased, while the level of IL-10, FEV and the PaO were markedly decreased in the three COPD groups prior to treatment. Following treatment, the induced sputum IL-8 level and the PaCO were significantly decreased, while the induced sputum IL-10 level, FEV and the PaO were markedly increased in the three treatment groups compared with the values pre-therapy (all P<0.01). The post-treatment parameters were significantly different among the three groups (P<0.01). The results indicate that IL-8 and IL-10 are involved in the airway inflammation of AECOPD complicated by CCP. Treatment with an ICS was demonstrated to be a successful method of reducing the local expression of IL-8 and increasing the local expression of IL-10; however, ICS combined with a long-acting β-adrenoceptor agonist (LABA) was more effective than the sole administration of ICS in patients with AECOPD complicated by CCP at high altitude.
本研究旨在评估高海拔地区慢性阻塞性肺疾病急性加重期（AECOPD）合并慢性肺源性心脏病（CCP）患者诱导痰中白细胞介素（IL）-8和IL-10水平，并评价吸入性糖皮质激素（ICS）和β-肾上腺素能受体激动剂对该疾病的干预效果。将186例AECOPD合并CCP患者随机分为三组，每组62例。对于两个治疗组，A组采用沙美特罗/氟替卡松（分别为50μg/250μg）经气道吸入，每日两次，而B组接受布地奈德（1mg）喷雾吸入，每日两次。常规治疗组（C组）仅接受常规治疗。在入院时及治疗后两周病情稳定阶段，检测诱导痰中IL-8和IL-10水平以及一秒用力呼气容积（FEV）预计值百分比、动脉血氧分压（PaO）和动脉血二氧化碳分压（PaCO）。40名健康志愿者作为对照组（D组）。与D组数值相比，三个慢性阻塞性肺疾病组治疗前诱导痰IL-8水平和PaCO显著升高，而IL-10水平、FEV和PaO显著降低。治疗后，三个治疗组诱导痰IL-8水平和PaCO显著降低，而诱导痰IL-10水平、FEV和PaO与治疗前相比显著升高（均P<0.01）。三组治疗后参数差异有统计学意义（P<0.01）。结果表明，IL-8和IL-10参与了AECOPD合并CCP的气道炎症。ICS治疗被证明是降低IL-8局部表达和增加IL-10局部表达的成功方法；然而，在高海拔地区AECOPD合并CCP患者中，ICS联合长效β-肾上腺素能受体激动剂（LABA）比单独使用ICS更有效。
