Study Of Evaluation And Clinical Application Of Impulse Oscillometry And Expression Of IL-13 Andd IL-18 In Patients With Chronic Obstructive Pulomonary Disease

Objective To assess impulse oscillometry pulmonary function and expression of interleukin-13 (IL-13) and interleukin-18 (IL-18) in patients with chronic obstructive pulmonary disease (COPD).Methods To select 85 cases which were diagonoised as COPD in the department of respiratory in the second clinical hospital of Shanxi medical university, these patients were divided into mild 9 cases,moderate 21 cases,severe 35 cases and very severe 20 cases.There were 50 cases in stable period and 35 cases during acute period.The impedance of respiratory system was measured by impulse oscillometry system (IOS) and compared with parameters of routine pulmonary ventilation function.The serum levels of IL-13 and IL-18 were analyzed using enzyme-linked immunosorbent assays (ELISA)Resoults 1.FEV1,FVC,FEV1/FVC% and FEV1/pre% of the COPD group were signif-icantly lower than those of the control group(P<0.05).The more advanced the COPD the more descended the above parameters. FVC and FEV1/pre% had significant differences(P<0.05).2. There was a significant increase in respiratory impedance at 5Hz(Z5),respiratory resistance(R) at 5Hz,resonant frequency(Fres) in the COPD group compared to those within the healthy group (P＜0.01).Reactance(X) at 5Hz in the COPD group was markedly lower than that in the healthy group (P<0.01).The more advanced the COPD the more increased Fres.3. Z5,R5,R20 and Fres were negatively correlated with parameters of pulmonary ventilation(P<0.05).Reversely, X5 was positively correlated (P＜0.01).The closest correlation was Fres.4.The expression of IL-13 and IL-18 were up-regulated in serum of the COPD patients,either clinically stable or acute period,as compared with the control group (P<0.01).Also,the expression of IL-13 and IL-18 during acute exacerbation of COPD increased significantly compared to the stable COPD (P＜0.01).5. IL-13 and IL-18 respectively had significant negative correlation with FEV1,FVC,FEV1/FVC% and FEV,/pre% in COPD group(P<0.01).6. IL-13 and IL-18 respectively had significant positive correlation with Z5,R5 and Fres in COPD group (P<0.01).IL-18 had a significant positive corre--lation with the R20 in COPD group (P<0.05). IL-13 and IL-18 respectively had significant neg-ative correlation with X5 in COPD group (P<0.01).Conclusions 1. Parameters measured by IOS can reflect the dynamic characteristics about respiratory physiology of COPD patients, which are sensitive indexes to figure out the obstructed parts, obstructed degrees and compliance.IOS can assist routine pulmonary ventilation function to diagnose COPD.2.IL-13 and IL-18 participate in the occurrent and developing stages of COPD.They could reflect obstructed parts and obstructed degree.They could be considered as important indexes about the state of COPD.3.Measure IL-13 and IL-18 to estimate the state of COPD for patients who cannot tolerate pulmonary function and areas where pulmonary function cannot be carried out,as IL-13 and IL-18 can indirectly reflect the obstructed parts and obstructed degrees.4. IL-13 and IL-18 may contribute to diagnosis and estimate conditions for mild patients and moderate patients,which can achieve the purpose of early intervention.