慢性阻塞性肺疾病肺动脉高压的发病率及其与炎症标志物白细胞介素-1的关系

Sherif Ahmed Eissa, Youssef Mohamed Amin Soliman, Tarek Samy Essawy, Mostafa Mohammed Abdelrahman Elsayed, Nashwa Ahmed Amin
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摘要

许多慢性阻塞性肺病(COPD)患者都有严重的肺血管阻力(PH),右心导管检查(RHC)测得的肺血管阻力(PVR)大于 5 WU。白细胞介素-1(IL-1)被认为是一种主要的细胞因子,可能与这些患者 PH 的发生有关。本研究旨在确定慢性阻塞性肺病 PH 的发病率及其与炎症标志物 IL-1 的关系。100 名慢性阻塞性肺病患者接受了超声心动图检查和血清 IL-1 分析,PH 可能性高的患者使用 Swan-Ganz 导管接受了肺动脉导管检查。平均血清 IL-1 水平为 82 pg/ml ± 22 pg/ml(已知正常 IL-1 血清水平为 0:5 pg/ml),51% 的参与者被归类为 PH 可能性低,35% 为中度,14% 为高度。RHC 结果如下:14.3% 的患者被诊断为轻度合并毛细血管前后 PH。轻度毛细血管前 PH 占 42.9%,是最常见的类型。21.4%的患者被诊断为重度毛细血管前后 PH。14.3%的患者存在重度毛细血管前 PH。血清IL-1与三尖瓣反流速度(TRV)(r = 0.409,P < 0.001)、估计肺动脉收缩压(ESPAP)(r = 0.508,P < 0.001)和平均肺动脉压(mPAP)(r = 0.410,P = 0.140)之间呈明显正相关。血清IL-1是慢性阻塞性肺病患者高PH概率的有力预测因子,血清IL-1与慢性阻塞性肺病患者的超声心动图结果、PH概率和RHC结果之间存在显著的正相关。
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Incidence of pulmonary hypertension in COPD and its relation to inflammatory marker interleukin-1
Many COPD patients present with severe PH defined by a pulmonary vascular resistance (PVR) > 5 WU as measured by right heart catheterization (RHC), and inflammation is thought to be contributing strongly to pulmonary vascular remodeling in COPD besides hypoxia. Interleukin-1 (IL-1) is thought to be a major cytokine that may be involved in development of PH in these patients. This study aimed to identify the incidence of PH in COPD and its relation to inflammatory marker IL-1. One-hundred COPD patients underwent echocardiography and serum IL-1 analysis, and patients with high probability of PH underwent pulmonary artery catheterization using Swan-Ganz catheter. The mean serum IL-1 level was 82 pg/ml ± 22 pg/ml (the normal IL-1 serum level is known to be 0:5 pg/mL), 51% of the participants were categorized as having a low probability of PH, 35% was intermediate, and 14% was high. RHC results were as follows: mild combined pre- and postcapillary PH was diagnosed in 14.3% of the patients. Mild precapillary PH was found in 42.9%, making it the most common type. Severe combined pre- and postcapillary PH was noted in 21.4% of the patients. Severe precapillary PH was present in 14.3%. A significant positive correlations were observed between serum IL-1 and tricuspid regurgitation velocity (TRV) (r = 0.409, P < 0.001), estimated systolic pulmonary artery pressure (ESPAP) (r = 0.508, P < 0.001), and mean pulmonary artery pressure (mPAP) (r = 0.410, P = 0.140). Serum IL-1 is a potent predictor of a high probability of PH in COPD patients, and there was significant positive correlation between serum IL-1 and echocardiographic findings and PH probability and RHC findings in COPD patients.
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