The Correlation Study Of Chronic Obstructive Pulmonary Disease Complicated By Cor Pulmonale And IL-6 And IL-10

ObjectiveTo explore the correlation between cor pulmonale in patients of chronic obstructive pulmonary disease(COPD)with interleukin 6(IL-6)and Interleukin10(IL-10),and to determine its influencing factors and clinical significance.MethodsFrom November 2015 to January 2018,60 patients with chronic obstructive pulmonary disease(group B)and 60 patients with early pulmonary heart disease(Group A)were selected to collect all the general clinical data,collect whole blood,extract serum,and use enzyme linked immunosorbent assay(ELISA)to detect IL-6 and IL-10 levels.The data collected by two groups of patients were statistically analyzed..Results1.Comparison of basic data between the two groups: There was no significant difference between the two groups on sex,age,smoking,alcohol consumption,diabetes,hypertension,and the severity of COPD(P>0.05).The course of disease in group A was longer than that in group B(P<0.05).The body mass index(BMI)of group A was higher than that of group B(P<0.05).2.Comparison of blood routine,hypersensitive C reactive protein,Tumor necrosis factor-?,pulmonary function,blood gas analysis: There was no significant difference between the two groups on erythrocyte count,hemoglobin,leukocyte count,percentage of neutrophils,forced expiratory volume in one second % of projected value,percentage of vital capacity occupied by forced expiratory volume in the first second and PaCO2(P<0.05).In group A,The hs-CRP,hematocrit TNF-?,pulmonary arterial systolic pressure and pH were higher than those in group B,and the difference was statistically significant(P< 0.05).The PaO2 of group A was lower than that of group B(P< 0.05).3.Compare the two groups with IL-6 and IL-10 levels in stable phase of disease:The level of serum IL-6 in group A was higher than that in group B,the difference was statistically significant(P<0.05),and the level of IL-10 in group B was lower than that in group B(P<0.01).4.Compare the level of IL-6,IL-10 and right ventricular ejection fractionation level(RVEF)in different cardiac function grades(NYHA grade)of group A: The level of IL-6 in patients with heart function grade I was lower than that in patients with heart function II(P< 0.05).The IL-10 and RVEF in patients with heart function grade I were higher than those in patients with cardiac function grade II(P<0.05).5.The comparison of multiple pro-inflammatory cytokines in two groups in the acute phase of disease:The level of IL-8 in group A was slightly higher than that in group B(P>0.05),the level of IL-6 and IL-18 in group A was significantly higher than that in group B(P<0.05),and the level of IL-10 and NO in group A was lower than that in group B(P<0.05).6.Correlation and multiple stepwise regression analysis:(1)The results of Spearman correlation analysis showed that the level of IL-6 in acute stage of groups A was positively correlated with PASP,Hs-CRP(P< 0.05),and negatively correlated with the PaO2,NO,RVEF(P<0.05),and was no significant correlation with disease duration,BMI,hematocrit,pH,TNF-?,and IL-18(P> 0.05);In stable stage of groups A,there was a positive correlation between IL-6 and PASP,Hs-CRP(P<0.05),a negative correlation between IL-6 and PaO2,NO,RVEF(P<0.05),and no significant correlation between IL-6 and disease duration,BMI,hematocrit,pH,TNF-?,IL-18(P>0.05);In acute phase of groups A,IL-10 was positively correlated with PaO2,NO,RVEF(P<0.05),and negatively correlated with PASP(P<0.05),and there was no significant correlation between IL-10 with time of course,BMI,hematocrit,Hs-CRP,pH,TNF-?,IL-18(P>0.05);In stable stage of groups A,there was a negative correlation between IL-10 and PASP(P<0.05),and there was no significant correlation between IL-10 and disease duration,BMI,hematocrit,Hs-CRP,pH,TNF-?,IL-18,PaO2,NO,RVEF(P>0.05)(2)The results of multiple stepwise regression analysis showed that of group A,PaO2,RVEF,PASP influence the level of IL-6 n stable stage and in acute stage,and PaO2,PASP influence the level of IL-10 in acute stage.Conclusions1.IL-6 increased while IL-10 decreased in COPD complicated with early pulmonary heart disease.2.There is a certain correlation between IL-6 and PASP,Hs-CRP,PaO2,NO,RVEF.There is a certain correlation between IL-10 and NO,RVEF,PASP.3.IL-6 and IL-10 may be involved in the progression of chronic obstructive pulmonary disease complicated by cor pulmonale,which can be used as a reference for the prediction of chronic obstructive pulmonary heart disease and observing the condition of the disease.4.Increasing oxygen partial pressure,improving right heart function and decreasing pulmonary systolic pressure could delay the progression of chronic obstructive pulmonary disease to cor pulmonale.