Study on the relationship between pulmonary arterial hypertension associated with chronic obstructive pulmonary disease and inflammatory reaction / 中国综合临床

ABSTRACT

Objective To explore the relationship between pulmonary arterial hypertension (PAH)associat-ed with chronic obstructive pulmonary disease (COPD) and inflammatory reaction(inflammatory cell, bs CRP, IL-8 and TNF-α). Methods According to echocardiography results, the patients (systolic pulmonary artery pressure, SPAP>30 mm Hg) were divided into PAH group(n=36), single COPD group(n=32). All of the patients and 30 healthy subjects (control group) were recruited into the study. Lung function, arterial blood gases, cell differentials in induced sputum, and the levels of serum high sensitivity CRP(hs-CRP), IL-8, TNF-α were determined. Results The incidence of PAH associated with COPD were 53% (36/68),including 27% (3/11) of mild PAH,38% (5/13) of moderate PAH and 64% (28/44) of severe PAH and there were significantly differences in the severity of the spirometric abnormality (χ26.020, P<0.05). The mean PASP and right ventricle wall thickness (RVWT) in PAH group were significantly greater in the patients compared to single COPD[PASP (52±15)mmHg in PAH group and (23±12) mm Hg in single COPD group, t=3.32,P<0.01 ; PVWT (5.03±1.04 )mm in PAH group and (3.78±0.57)nun in single COPD group, t=2.36, P<0.05]. The levels of total cell count and neutrophils in induced sputum,hs-CRP,IL-8 and TNF-α in PAH group were higher than those in single COPD group and healthy subjects[toal cell count (2.84±0.56)×109/L in PAH group and (1.73±0.42)×109/L in single COPD group and (0.68±0.21)×109/L in control group; neutrophils (2.78±0.52)×109/L in PAH group and (2.57± 0.26)×109/L in single COPD group and (0.63±0.21 )×109/L in control group; hs CRP (32±12) mg/L in PAH group and (23±11)mg/L in single COPD group and (11±4)mg/L in control group; IL-8 (113±34) ng/L in PAH group and (69±24) ng/L in single COPD group and (38±11) ng/L in control group; TNF-α (206±63)ng/L in PAH group and (153±54)ng/L in single COPD group and (75±26)ng/L in control group (P<0.05)]. PASP in PAH group was negatively correlated with FEV<,1>% (r=-0.48,P<0.01) and was positively correlated with the levels of serium IL-8 and TNF-α, neutrophils in induced sputum respectively(r=0.43,0.56,0. 47,P<0.01). Conclusion Inflammation reaction is responsible for PAH associated with COPD.