| Objective: Chronic Obstructive Pulmonary Disease (COPD) is a kind of common and frequently-occurring respiratory disease. Many studies show that inflammation is a central part of the pathogenesis of COPD, a variety of inflammatory cells, cytokines, adhesion molecules and chemo tactic factors participate in the occurrence and development of the COPD. Soluble Intercellular Adhesion Molecules-1(sICAM-1) is one of the mostly researched adhesion molecules in recent years. By the detection of COPD patients'sICAM-1 and inflammatory mediators (IL-10, IL-18), this paper conducts a study to investigate the relationship between sICAM-1, inflammatory mediators and the pathogenesis of COPD, and thus make a better understanding of effects that sICAM-1 and inflammatory medium have in the forming of the mechanism of airway inflammation in COPD patients. And its relationship with the severity of patients with COPD, then provides new ways for the prevention and control of COPD.Methods:AECOPD patients as the observation group: 30 cases, are our internal hospitalization breathing acute exacerbations of COPD patients with severe diseases during September 2010 and February 2011, aged from 55 to 80 years, and their average age is (66.7±8.5) years. Based on the blood gas analysis, the 30 patients are divided into two subgroups: 20 patients with respiratory failure group and 10 patients without respiratory failure. COPD patients in the stable period: when in hospitalization, the AECOPD patients of 30 cases are given oxygen, antibiotics, spasmolysant and other conventional treatment. After two weeks, the symptoms and signs of improvement will in the clinical remission period, which will be regarded as a stable COPD group.Control group: 20 cases are health check-up in our hospital during September 2010 and February 2011. By detecting the disease history, physical examination, urine, biochemical examination, X-ray chest radiograph and pulmonary function exclude diabetes, heart, liver, kidneys, lungs, brain organic lesion, and they are without any systemic infections history for the recent two months. Ages from 55 to 80 years, and their average age is (65.5±9.2) years.COPD patients of acute acerbation before treatment, after treatment and in the control groups will take 5ml median cubital vein blood. Room temperature, centrifuged 3 000r/min, centrifuge 5min.Then make the serum into eppendoff tube in the temperature of -80℃for the preparation of uniform testing. After the collection use enzyme-linked immunosorbent adsorption double antibody clip method (ELISA) to detect the content of serum sICAM-1, IL-10, IL-18, strictly according to the specifications operated by specialist. Datas are analyzed by software SPSS16.0, the experimental datas are expressed by(±s), inspected by t test and correlation coefficient, P<0.05 has statistical significance.Results:(1) The levels of serum sICAM-1, IL-10, IL-18 in the AECOPD group, COPD group in the stable period and the control group:The levels of serum sICAM-1, IL-10, IL-18 in the AECOPD group are (160.99±45.67)μg/L,(3.30±0.89)pg/ml,(421.04±64.12)pg/ml. The levels of serum sICAM-1, IL-10, IL-18 in the COPD patients of stable period are (137.79±25.68)μg/L,(8.28±3.25)pg/ml,(275.39±53.93)pg/ml. The levels of serum sICAM-1, IL-10, IL-18 in the control group are (63.15±29.73)μg/L,(17.31±6.61)pg/ml,(48.78±52.05)pg/ml. The levels of serum sICAM-1 and IL-18 in the AECOPD group are higher than that in the COPD patients of stable period and control group, the differences are statistically significant in the binary comparison, P<0.05. The levels of serum IL-10 are lower than that in the COPD patients of stable period and control group, the differences are statistically significant in the binary comparison, P<0.05. The levels of serum sICAM-1 and IL-18 in the COPD patients of stable period are lower than that in the control group, the differences are statistically significant in the binary comparison, P<0.05. The levels of serum IL-10 are lower than that in the control group, the differences are statistically significant in the binary comparison, P<0.05. (2) The levels of sICAM-1,IL-10 and IL-18 in the AECOPD patients complicated with respiratory failure group and the group without respiratory failure: The levels of serum sICAM-1,IL-10,IL-18 in the AECOPD patients group complicated with respiratory failure are (187.96±83.24)μg/L,(2.95±0.90)pg/ml,(459.94±29.25) pg/ml. The levels of serum sICAM-1,IL-10,IL-18 in the AECOPD patients group without respiratory failure are (107.37±42.18)μg/L,(3.91±0.35)pg/ml,(348.31±38.75)pg/ml. The levels of serum sICAM-1,IL-18 in the AECOPD patients group complicated with respiratory failure are higher than that in the AECOPD patients group without respiratory failure, the differences are statistically significant in the binary comparison, P<0.05. The levels of serum IL-10 in the AECOPD patients group complicated with respiratory failure are lower than that in the AECOPD patients group without respiratory failure, the differences are statistically significant in the binary comparison, P<0.05.(3) The relevance of the content of serum sICAM-1 and serum IL-10, IL-18 in AECOPD patients:The serum levels of sICAM-1 in the AECOPD patients are decreasing with the increasing of serum levels of IL-10, they have a negative correlation (correlation coefficient r =-0.46, P = 0.006). The serum levels of sICAM-1 in the AECOPD patients are increasing with the increasing of serum levels of serum IL-18, they have a positive correlation (correlation coefficient r=0.62, P<0.001).Conclusion:(1) The levels of sICAM-1 and IL-18 in AECOPD group and stable COPD group are higher than that in the control group, the serum levels of sICAM-1 and IL-18 have a positive correlation in the AECOPD patients, indicating that sICAM-1, IL-18 joint involved in the inflammatory process of COPD and sustentation of chronic inflammation.(2) The levels of serum sICAM-1and IL-18 levels in AECOPD patients complicated with respiratory failure are higher than that in the AECOPD patients without respiratory failure, indicating that sICAM-1, IL-18 are the indicators reflecting the severity of COPD.(3) The level of IL-10 reverses the above changes, indicating that IL-10 is the main inhibitor of inflammation in COPD. |
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