The Effect Of PM2.5 On Serum Levels Of TNF-?,IL-6,IL-8 And Quality Of Life In Patients With Chronic Obstructive Pulmonary Disease By Panel Study

BackgroundChronic obstructive pulmonary disease(COPD)is one of the most common respiratory system disease,and the progressive development,and professional and lungs on cigarette smoke,indoor and outdoor and environmental exposure of air dust particles,pathogenic microorganism and other material related to the abnormal immune inflamm-atory response,is a kind of can the prevention and treatment of chronic inflammatory diseases.COPD is located in the world's fourth in the cause of death,the change of the population age structure and high mortality rate of chronic obstructive pulmonary disease itself in our country to realize the standardization of the COPD prevention put forward a huge challenge.ObjectiveResearch with different concentrations of Hami PM2.5 in COPD patients with chronic airway inflammation factor serum tumor necrosis factor alpha(TNF-a),interleukin 6(IL-6),interleukin 8(IL-8)and and the influence of the quality of life,provide the basis for the clinical prevention and treatment of COPD.Methods60 patients with COPD in our hospital from January 2015 to December 2015 were included in the study.The study method was panel,and integrated the community as one unit.7545 type indoor air quality monitor and air quality on-line monitoring DISIBI1000-7201 system investigate indoor and outdoor PM2.5 around the patients with COPD during a week in March,June,September and December.Then we should monitor the pulmonary function of COPD patients for continuous five days,collect the venous blood and complete the test of the frequency of acute exacerbation,6-minute walk distance,CAT questionnaire in the seventh day.The content of TNF-?,IL-6 and IL-8 were tested by ELISA;the difference between four seasons for pulmonary function and life quality was analyzed by one-way analysis of variance;the correlation of lung function,life score and PM2.5 in different seasons was measured by Spearman correlation analysis and multivariate linear regression analysis method,in order to the influence of PM2.5 exerted on on chronic airway inflammatory factor and the quality of life of COPD.Results(1)The outdoor PM2.5 exposure index of COPD patients was higher than that of indoor in each season.The trend of PM2.5 concentration in four seasons was winter>spring>summer>autumn,which has statistical significance(P<0.05).(2)The difference of FEV1.0/FVC and VC of COPD patients were significant statistically during the inspection day.Moreover,there was negative correlation between PM2.5 exposure levels and FEV1.0 at the indoor and outdoor atmosphere.(3)The time delayed effects of PM2.5 for COPD patients mainly rest on lag3,lag5,with accumulation of main airway in winter seasons.In autumn,there were statistical differences of FVC(lag3,lag4)and FEV1.0/FVC(lag 4,lag5).In winter,the differences of FVC(lag4),FEV1.0(lag2,lag3,lag4),FEV1.0/FVC(lag2,lag3,lag 4,lag5)were obvious.Other differences in these seasons were not statistical.(4)The accumulated e delayed effects of PM2.5 for COPD patients mainly rest on lag0-4 and lag0-6,with mainly in winter.In autumn,FEV1.0/FVC(lag0-5,lag 0-6)was different statistically.In winter,FEV1.0/FVC and VC(lag0-4,lag0-5,lag 0-6),FVC(lag0-5,lag 0-6)and FEV1.0(lag0-5,lag 0-6)were also different statistically.(5)There were significant differences in the frequency of acute exacerbation,6-minute walk distance and CAT scores of COPD patient in different seasons(P<0.05).And acute exacerbation and CAT scores displayed positive correlation with PM2.5 exposure(r =0.837,r = 0.723;P<0.05).But the 6-minute walk distance was negatively correlated with PM2.5 exposure(r =-0.441,P<0.05).In addition,CAT scores were positively correlated with acute exacerbation(r = 0.843,P = 0.021).(6)There were significant differences in the average content of TNF-,IL-6 and IL-8 in the serum of COPD patients between the four seasons(P<0.05).And correlation between the level of TNF-a,IL-6,IL-8 and the PM2.5 exposure was positive(r=0.786,r=0.705,r=0.392,P<0.05).Other indicators were independent.ConclusionHigh concentration of PM2.5 exposure increased the chronic inflammatory response in COPD patients,which directly affected the quality of life in patients with COPD.