咽喉反流、炎症因子与慢性阻塞性肺疾病 急性加重的相关性研究

Correlation between laryngopharyngeal reflux (LPR) and inflammatory factors and acute exacerbation of COPD

摘要:

目的 探讨咽喉反流（LPR）和炎症因子与慢性阻塞性肺疾病（COPD）急性加重的相关性研究。 方法 选取2017 年6 月—2018 年7 月丽水市人民医院收治的387 例COPD 患者作为研究对象，其中分为 急性加重患者185 例（急性加重组）、稳定期患者202 例（稳定组）；另选取同期于该院体检的健康者67 例 作为对照组。采用碳13 呼气试验检测反流症状指数和反流体征指数；采用酶联免疫吸附法测定肿瘤坏死因 子α（TNF-α）、白细胞介素2（IL-2）、白细胞介素6（IL-6）及白细胞介素8（IL-8）含量。结果 急 性加重组反流症状指数、反流体征指数高于稳定组和对照组（P <0.05）；稳定组反流症状和反流体征指数高 于对照组（P <0.05）。急性加重组血清TNF-α、IL-6 及IL-8 水平高于稳定组和对照组，而血清IL-2 水平 低于稳定组和对照组（P <0.05）。稳定组和对照组炎症因子水平比较，差异无统计学意义（P >0.05）。反流 症状指数和反流体征指数与TNF-α、IL-6 及IL-8 呈正相关（P <0.05），而与IL-2 呈负相关（P <0.05）。 结论 LPR 和炎症因子与COPD 急性加重期相关性较高，且LPR 与TNF-α、IL-6 和IL-8 呈线性正相关， 而与IL-2 呈线性负相关。

Abstract:

Objective To investigate the relationship between laryngopharyngeal reflux (LPR) and inflammatory factors and acute exacerbation of chronic obstructive pulmonary disease (COPD). Methods From June 2017 to July 2018, 387 patients with COPD were selected as subjects, including 185 patients with acute exacerbation and 202 patients with stable phase; another 67 healthy subjects in our hospital from June 2017 to July 2018 were selected as control group. The reflux symptom index and reflux sign index were measured with carbon 13 breath test; tumor necrosis factor-a (TNF-a), interleukin-2 (IL-2), interleukin-6 (IL-6) and interleukin-8 (IL-8) were measured by enzyme linked immunosorbent assay (ELISA) content. Results The reflux symptom index score and reflux sign index score of the acute aggravation group were higher than those of the stable group and the control group (P < 0.05). The scores of reflux symptom index and reflux sign index in the stable group were higher than those in the control group (P < 0.05). Serum levels of TNF-a, IL-6 and IL-8 in acute exacerbation group were higher than those in stable group and control group, while serum levels of IL-2 were lower than those in stable group and control group.There was no significant difference in inflammatory factors between the stable group and the control group (P > 0.05). The reflux symptom index and reflux sign index were positively correlated with TNF-a, IL-6 and IL-8 (P > 0.05), but negatively correlated with IL-2 (P > 0.05). Conclusions LPR and inflammatory factors were highly correlated with acute exacerbation of COPD, and LPR was positively correlated with TNF-a, IL-6 and IL-8, but negatively correlated with IL-2.