ABSTRACT
Objective:To investigate the changes of inflammatory indicators in patients with chronic obstructive pulmonary disease (COPD) and to analyze the related factors.Methods:From January 2018 to January 2019, 500 patients with COPD in the Sixth People's Hospital of Zhuji were selected.According to whether the infection was occurred, the patients were divided into observation group and control group.The observation group was 286 COPD patients (57.20%) complicated with pulmonary infection, and the control group was 214 patients (42.80%) without infection.The inflammation indicators of the two groups[serum interleukins (IL-1β, IL-2, IL-4, IL-6, IL-8, IL-10), tumor necrosis factor (TNF-α, TNF-β) and interferon (IFN-α, IFN-γ)]were detected and analyzed, and the relevant factors that caused infection were analyzed.Results:The serum interleukins (IL-1β, IL-2, IL-4, IL-6 and IL-10) in the observation group were significantly higher than those in the control group, and IL-8 level in the observation group was lower than that in the control group[(4.77±0.78)ng/L vs.(26.57±3.87)ng/L], the differences were statistically significant ( t=7.059, 67.098, 17.886, 17.259, 92.807, 17.181, all P<0.05). The levels of TNF-α, TNF-β and IFN-α in the observation group were higher than those in the control group[(48.81±11.53)μg/L vs.(33.91±10.84)μg/L, (95.36±17.87)ng/L vs.(46.12±12.18)ng/L, (26.81±4.45)ng/L vs.(7.78±3.54)ng/L], IFN-γ level in the observation group was lower than those in the control group[(46.25±10.09)pg/L vs.(55.67±14.23)pg/L], the differences were statistically significant ( t=14.666, 34.719, 51.532, 8.658, all P<0.001). The age≥60 years old (75.52% vs.49.07%), hospitalization time[(25.63±6.76)d vs.(20.53±5.87)d], antibiotic use time[(21.54±3.87)d vs.(13.50±4.21)d], diabetes history(77.27% vs.53.74%), mechanical ventilation(69.23% vs.10.28%), application of glucocorticoids(44.75% vs.69.16%) between the two groups had statistically significant differences (χ 2=37.285, t=8.824, 22.133, 30.759, χ 2=172.640, 29.478, all P<0.05). Logistic regression analysis showed that age≥60 years, diabetes history, antibiotic use time, mechanical ventilation, and application of glucocorticoid were the influencing factors of pulmonary infection in patients with COPD ( OR=1.527, 6.386, 2.801, 2.632, 2.084, all P<0.05). Conclusion:The detection of inflammatory factors (especially IL-8, IL-2) in COPD patients with pulmonary infection has clinical significance in the diagnosis and treatment of pulmonary infection.Long-term application of antibiotics, mechanical ventilation, and the application of glucocorticoids can easily lead to pulmonary infection in COPD patients.Therefore, preventive measures can be taken according to relevant factors in the clinic.