Expression Of Tumor Necrosis Factor-α、Interleukin-6 And Interleukin-8 In Patients With The Overlap Syndrome And Its Significance

Objective:To detect the levels of the serum inflammatory factor tumor necrosis factor-α, interleukin-6 and interleukin-8 in patients with overlap syndrome and to investigate if these inflammatory factors is associated with hypoxemia during sleep. To explore possible etiology of inflammatory factor in overlap syndrome from the point of systemic inflammatory response and provide condition for treatment and prognosis.Methods:The general situations in all of the subjects were detected and monitored by pulmonary function and polysomnography(PSG). Thirty patients with obstructive sleep apean-hypopean syndrome, thirty patients with stable chronic obstructive pulmonary disease, thirty patients with the overlap syndrome and thirty healthy controls were recruited. The levels of serum TNF-α, IL-6 and IL-8 were measured by the enzyme linked immune sorbent assay(ELISA). To compare the pulmonary function index, sleeping respiratory index between each group and the levels of serum TNF-α, IL-6 and IL-8, and the correlation analysis were made between the serum TNF-α, IL-6, IL-8 and sleeping respiratory index in OS, OSAHS and COPD group.Results: ①FEV1/FVC, FEV,%pred and MVV%pred in OS group, OSAHS group and COPD group were lower than the normal group(P<0.05), and FEV1/FVC, FEV)%pred, MVV%pred in OS group was significantly lower than those in OSAHS group and COPD group(P<0.05).②AHI and TSpO2<90% in OS group and OSAHS group were significantly higher than those in COPD group and normal group(P<0.05). AHI and TSpO2<90% in OS group were higher than those in OSAHS group(P<0.05). LSpO2 in OS group was significantly lower than those in other three groups (P<0.05).③The levels of serum TNF-α, IL-6 and IL-8 in OS group, OSAHS group and COPD group were all higher than those in normal group (P<0.01). The levels of serum TNF-α, IL-6 and IL-8 in OS group were higher than those in OSAHS group and COPD group(P<0.05). ④TNF-α, IL-6 and IL-8 in OS, OSAHS group showed positive correlation with AHI and TSpO290% but negative correlation with LSpO2; TNF-α, IL-6 and IL-8 in COPD group showed positive correlation with TSpO290% but negative correlation with LSpO2.Conclusion:①There is a more pronounced nocturnal hypoxemia that was related with sleeping in the OS group; ②The high expression of serum TNF-α, IL-6 and IL-8 in OS group prompts that there is more intense systemic inflammatory reaction in patients with OS and play an important role in the pathogenesis of OS.③There is more intense systemic inflammatory response in OS patients, which may give priority to with OSAHS;④The levels of serum TNF-α, IL-6 and IL-8 closely correlate with the severity and nocturnal 4ypoxemia degree in patients with OS, these inflammatory factors might as important predictors on assessing the severity and the prognosis.