【摘要】 目的:研究白介素-6(IL-6)和内皮素-1(ET-1)在慢性阻塞性肺疾病(COPD)合并肺动脉高压(PH)患者和COPD无PH患者中的表达水平。方法:66例COPD合并PH患者和64例COPD无PH患者,检测IL-6和ET-1水平,心脏多普勒检测肺动脉收缩压力(PASP),PASP≥36mmHg为PH,检查肺功能、动脉血气、6min步行距离。结果:COPD合并PH患者IL-6和ET-1水平高于COPD无PH患者,分别是中位数3.6pg/L(四分位间距2.3～4.9pg/L)与中位数2.3pg/L(四分位间距1.2～3.7pg/L),差异有统计学意义(z=-2.756,P<0.01);中位数4.7pg/L(四分位间距,1.8～7.9pg/L)与中位数1.5pg/L(四分位间距,0.9～3.7pg/L),差异有统计学意义(z=-2.945,P<0.01)。所有患者IL-6和ET-1水平呈正相关(r=0.782,P=0.001);肺动脉压力水平与IL-6(r=0.381,P=0.001)和ET-1(r=0.529,P=0.001)水平有关;6min步行距离分别和氧分压负相关(r=-0.728,P=0.032),和ET-1正相关(r=0.625,P=0.001),和IL-6正相关(r=0.461,P=0.001)。结论:IL-6和ET-1可能与COPD并PH形成有关,具体机制有待进一步研究。更多还原

【Abstract】 Objective To investigate the expressions of interleukin-6(IL-6) and endothelin-1(ET-1) in patients with chronic pulmonary disease(COPD) combined with or without pulmonary hypertension(PH).Methods The expressions of IL-6 and ET-1 in 66 patients with COPD combined with PH and 64 patients with COPD but without PH were detected.PH was defined as a systolic pulmonary artery pressure(PASP) ≥36 mmHg assessed by Doppler echocardiography.The lung function,arterial blood gases,6-minute walking distance were detected.Results The expressions of IL-6 and ET-1 in patients with COPD and PH were significantly higher than those in patients with COPD but without PH [median IL-6 levels were 3.6 pg /L(quartile range 2.3-4.9 pg /L) and 2.3 pg /L(quartile range 1.2-3.7 pg /L),z =-2.756,P < 0.01;median ET-1 levels were 4.7 pg /L(quartile range 1.8-7.9 pg /L) and 1.5 pg /L(quartile range 0.9-3.7 pg /L),z =-2.945,P < 0.01].The expressions of IL-6 and ET-1 were positively correlated(r = 0.782,P = 0.001).For COPD patients,PASP was significantly correlated with the levels of IL-6(r = 0.381,P = 0.001) and ET-1(r = 0.529,P = 0.001).The 6-min walking distance(6-MWD) was negatively correlated to PaO2(r =-0.728,P = 0.032) and was positively correlated to the levels of ET-1(r = 0.625,P = 0.001) and IL-6(r = 0.461,P = 0.001).Conclusions IL-6 and ET-1 may correlate with PH in patients with COPD,but the specific mechanisms are waiting for further study.更多还原