Clinical Hospital of Botucatu Medical School, Department of Internal Medicine, Pneumology Area, Botucatu School of Medicine, São Paulo State University (UNESP), Botucatu, São Paulo, Brazil.
Department of Internal Medicine, Pneumology Area, Botucatu School of Medicine, São Paulo State University (UNESP), Botucatu, São Paulo, Brazil.
Int J Chron Obstruct Pulmon Dis. 2021 Nov 3;16:3019-3026. doi: 10.2147/COPD.S328266. eCollection 2021.
Systemic manifestations of chronic obstructive pulmonary disease (COPD) are related to increased systemic inflammatory process; however, it is not entirely clear how much they are related and how the systemic inflammation, in particular interleukin-6 (IL-6), is associated with exacerbation and mortality risk.
To evaluate the role of IL-6 in COPD patients over nine years.
A total of 133 COPD patients were assessed at baseline between 2004 and 2006 and reassessed after three and nine years through clinical evaluation, comorbidities, hematological blood count and IL-6 analysis.
After nine years, 19 patients lost the follow-up and were not possible to identify the date of death of four patients; 12 refused to participate and 1 could not be involved due to recurrent exacerbations. Therefore, 33 patients were included in the reassessment after nine years of follow-up and 92 patients were included in the Cox mortality analysis with IL-6 as a time-dependent covariate. Regarding the inflammatory profile, in patients who survived after nine years, there was a significant increase in IL-6 [0.4 (0.2-0.8) vs 5.7 (3.4-11) pg/mL; p < 0.001] and reduction in lymphocyte count [2.1 (1.6-2.4) vs 1.4 (1.2-2.1)10^9/L; p < 0.01] with an increase in the neutrophil/lymphocyte ratio (2.0 ± 0.7 vs 2.7 ± 1.2; p = 0.003). The Cox mortality model did not show a statistical significance influence of IL-6 assessed during the follow-up.
There was a progressive increase in IL-6 during the follow-up, however, without influence on mortality.
慢性阻塞性肺疾病(COPD)的全身表现与全身炎症过程增加有关;然而,尚不完全清楚它们之间的关系以及全身炎症,特别是白细胞介素-6(IL-6)与加重和死亡风险的关系。
评估 IL-6 在 COPD 患者中 9 年的作用。
共评估了 133 例 COPD 患者,他们于 2004 年至 2006 年间在基线进行评估,并在 3 年和 9 年后通过临床评估、合并症、全血细胞计数和 IL-6 分析进行重新评估。
9 年后,有 19 名患者失去随访,4 名患者的死亡日期无法确定;12 名患者拒绝参与,1 名患者因反复加重而无法参与。因此,有 33 名患者在 9 年随访后进行了重新评估,92 名患者在 Cox 死亡率分析中包含了作为时间相关协变量的 IL-6。关于炎症特征,在 9 年后存活的患者中,IL-6 显著增加[0.4(0.2-0.8)比 5.7(3.4-11)pg/mL;p<0.001],淋巴细胞计数减少[2.1(1.6-2.4)比 1.4(1.2-2.1)10^9/L;p<0.01],中性粒细胞/淋巴细胞比值增加(2.0±0.7 比 2.7±1.2;p=0.003)。Cox 死亡率模型并未显示随访期间评估的 IL-6 具有统计学意义的影响。
在随访过程中,IL-6 呈逐渐增加趋势,但对死亡率无影响。