Diversification And Correlation Of Serum IL-27 And IL-33 Levels In Elderly Patients With COPD

Objective:With the increasing number of elderly people,the problems and challenges brought by the aging society are becoming more and more obvious.To explore diversification and correlation of serum IL-27 and IL-33 levels in elderly patients of acute exacerbation of chronic obstructive pulmonary disease patients?stable chronic obstructive pulmonary disease patients,and further research of the diversification of serum IL-27 and IL-33 levels in elderly patients with acute exacerbation of chronic obstructive pulmonary disease before and after treatment,in order to investigate the clinical value of serum IL-27 and IL-33levels in the elderly COPD patients.Methods:1.Research objects and grouping:Choice elderly patients in geriatrics of hospital of shanxi medical university first hospital treatment in November 2016 to October 2017.They are older than 60 years of age.Describe acute exacerbation of chronic obstructive pulmonary disease patients as acute exacerbation group,and stable of chronic obstructive pulmonary disease patients as stable group.Describe control person who test in our hospital physical examination and no other respiratory disease at the same time as control group.Some AECOPD patients treated 2 weeks and compare with before,as acute exacerbation before treatment group and acute exacerbation after treatment group.The inclusion criteria of acute exacerbation and stable of chronic obstructive pulmonary disease patients:?1?older than 60 years of age?2?in accordance with the guidelines of GOLD in 2016.Exclusion criteria:?1?at the same time there are other infectious diseases of the other system?2?the active or passive used systemic immune enhancer or immune inhibitors in nearly 3 months?3?with any viscera function failure,autoimmune disease,immunodeficiency,malignant tumor,etc.acute exacerbation group:44 acute exacerbation of chronic obstructive pulmonary disease patients who were older than 60 and eligible for inclusion and exclusion criteria.stable group:34 plateau of chronic obstructive pulmonary disease patients who were more than 60 years old and eligible for inclusion and exclusion criteria.control group:30 person who test in our hospital physical examination?no other respiratory disease and eligible for exclusion criteria at the same time.acute exacerbation before treatment group:16 patients in acute exacerbation group.acute exacerbation after treatment group:for the treatment of acute exacerbation before treatment group of patients using the guidelines of GOLD in 2016 to the standard treatment for treatment,including:low flow oxygen,antibiotics,atomizing inhaled bronchodilator expectorant,etc,used for hospital treatment for about 2 weeks,the illness is stable.2.Blood samples were extracted and tested:acute exacerbation and stable patients had blood drawn when they were not treated at the hospital,and some of the AECOPD patients were redrawn after two weeks of stable condition.All entrants was extracted 5 ml venous blood at dawn when fasting,to let stand at room temperature after 30 min to 3000r/min for 10 min,and separate the upper pale yellow serum by pipetting gun from vacuum vessels moved to 1.5 ml centrifuge tube,each vacuum vessel apply two centrifugal tube,each tube storage about 1 ml serum for standby.Then we edit the number and put them in-80?refrigerator.Serum IL-27 and IL-33 were determined by ELISA assay according to the kit instructions,using microplate reader to measure absorbance OD value determined at450 nm wavelength of monochromatic light.According to the standard of the concentration gradient and the OD value make standard curve and calculate the concentration of serum IL-27 and IL-33.3.Statistical methods:SPSS 23.0 statistical software was used to analyze the collected data.The counting data is checked by chi-square and said with constituent ratio.If the measurement data is normal distribution,one-way anova and t-test of the two independent samples are adopted and said with mean±standard?x±s?.If it is a non-normal distribution,kruskal-wallis H and mann-whitney U test are adopted and writed with median?quartile spacing?[M?P25,P75?].The data of AECOPD elderly patients before and after treatment were compared with the paired sample T test.Pearson and Spearman correlation analysis were used to test the correlation between factors.P<0.05 was considered to be statistically significant.Results:1.The serum IL-27,IL-33 and CRP levels were the highest in the acute exacerbation group,followed by the stable group,and the lowest in the control group.The difference between the two groups was statistically significant?P<0.05?.The acute exacerbation group of PaO₂ was lower than that of the stable group,and the difference was statistically significant?P<0.05?;The acute exacerbation group of blood gas PaCO₂ was higher than that of the stable group,and the difference was statistically significant?P<0.05?.2.The serum IL-27,CRP and blood gas PaCO₂ levels in acute exacerbation after treatment group were decreased compared with those in acute exacerbation before treatment group?P<0.05?;The level of PaO₂ was increased,and the difference was statistically significant?P<0.05?.The difference of the serum IL-33 level before and after treatment was not statistically significant?P>0.05?.3.The serum IL-27 level was positively correlated with CRP and PaCO₂ levels,and negatively correlated with PaO₂ levels.The serum IL-33 level was positively correlated with CRP and PaCO₂ levels,and negatively correlated with PaO₂ levels.There was also a positive correlation between serum IL-27 and IL-33 levels,P<0.05.Conclusion:The levels of serum IL-27 and IL-33 are related to the severity of disease in patients with COPD,which had certain clinical value in evaluating the severity of the disease and the therapeutic effect.