Study Of Severity And Correlation Of Impulse Oscillometry System Pumonary Function Test And PPARγ From Chronic Obstructive Pulmonary Disease

Objective PPARγis a regulator of lung inflammation and repair.it plays an important role In the anti-inflammatory and immune regulation. PPARγcould better assess the severity of COPDpatients than TNF-α, IL-6 and other inflammatory factors. Numerous studies have indicated that the expression of PPARγdown In acute inflammation. IOS technology is a new simple and sensitive method that is suitable for large number of people. Subjects do not have to do special breathing movements. The aims of this study are to develop a simple and sensitive detection of COPDpatients throngh a correlation analysis amid IOS and PPARγ.Methods To select 84 cases patients which were diagonoised as COPD in the department of respiration the second clinical hospital of Shanxi medical university, these patients were divided into mild 11 cases (stable period6, acute period 5)moderate 23 cases(stable period13, acute period 10),severe 30 cases(stable period14, acute period 16) and very severe 20 cases. (stable period19, acute period 1)All selected people were measured by impulse oscillometry pulmonary function and collected venous blood. RT-PCR assay using peripheral blood mononuclear cells in the expression of PPARγ, with the ELISA assay the expression of TNF-α.Results 1. Compared with the control group, there was a significant decrease in FEV1,FEV1/FVC,FEV1/pre in COPD groups(P<0.05); 2. The IOS indices including Z5,R5,R20,R5-R20,Fres,Rc,Rp increased significantly in COPD groups compared control group(P<0.05), and Fres,Rp,R5-R20 in severe and very severe cases rise obviously compared to mild, moderate cases,which weren't positively correlated with severity of the COPD.X5 decreased significantly in COPD groups compared with the control group(P<0.05), and lower in severe and very severe cases compared to mild cases and moderate cases,but it wasn't worse with development of the disease; 3. Z5,R5,R20,R5-R20,Fres,Rp were neglatively correlated with FVC,FEV1,FEV1/FVC,FEV1/pre,X5 was positively correlated(P<0.05),the closest correlation was found in Fres with the severity of the COPD; 4. The positive rate of diagnosis in Z5,R5,X5 increased with the development of COPD,but Rp was reversed.R20 wasn't found anything. Fres was found to be the highest positivity with the severity of the COPD; 5. The expression of PPARγin COPDⅠ,Ⅱ,Ⅲ,Ⅳgrade is no difference.COPD patients with acute and stable expression of PPARγin peripheral blood mononuclear cells was significantly reduced compared with the control group (P<0.05),the expression of PPARγduring acute period was lower than in stable period patients (P<0.05). The expression of PPARγduring acute periodwas neglatively correlated with R5-R20.(r=-0.582); 6. the expression of TNF-α(COPDⅠ,Ⅱ,Ⅲ,Ⅳgrade) were markedly increased than control group (P<0.05), the difference between groups was significant (P<0.05), COPDⅣgrade Fres and TNF-αcorrelated most closely (r=0.540); 7.acute period of COPD PPARγcorrelated most closelywith acute and stable TNF-α(r=-0.585,-0.526),PPARγinhibit TNF-αand other inflammatory mediators release through signaling pathway.Conclusions (1)there are no correlation between PPARγand the severity ofCOPD (2) The expression of PPARγin period of COPD (control group,stable,acute)has decreased gradually. Theexpressionof PPARγduring acute phase was neglatively correlated with R5-R20.(r=-0.582).it has indicated that PPARγplayed a significant role in Acute inflammation of COPD. (3) IOS can fully reflect the characteristics of respiratory physiological dynamics and is a sensitive index to confirm the presence of airflow limitation and evaluate severity of chronic obstructive disease. it can be used as the early detection indicator of COPD, and it deserves clinical application.