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Objective: Chronic obstructive pulmonary disease (chronic obstructive pulmonary disease, COPD) is a common and serious harm to human health, respiratory diseases, and in recent years, the incidence is increasing, and has been subject to the attention of the world. The study found that the COPD exacerbations after recovery is often incomplete, it not only reduces the quality of life of the patient, but also so that the probability of increased again elevated, time is shortened, as well as the state of health of the patient increasingly decreased. Therefore, early diagnosis and prevention of acute exacerbation of COPD is particularly important. Most scholars believe that, a strongly oxidative stress, over-expression of many cytokines in the airway is the leading cause of morbidity in COPD. Iso-prostaglandin (8-iso-PGF2a) the prostanoid metabolites discovered in recent years, is formed after cleavage of membrane lipid of arachidonic acid by free radicals attack, can be formed in vivo, and has chemical stability measured for the current the better biochemical indicators of oxidative stress. The purpose of this experiment is to be aggravated by acute period and stable COPD patients plasma 8-iso-PGF2a levels and lung function, in order to find a more lung function earlier biochemical indicators reflecting acute exacerbation of COPD, in order to achieve acute COPD exacerbation of Early diagnosis and early treatment. At the same time, we intend to observe the impact of smoking COPD patients with plasma levels of 8-iso-PGF2a and explore the acute exacerbation period and stable COPD patients plasma Th1/Th2 state, for the prevention of acute exacerbation of COPD and immune therapy and antioxidant treatment theory foundation. Methods: ELISA (Enzyme-linked immunoabsordent assay, ELISA) detected 38 cases of acute exacerbation of COPD (acute exacerbation of copd AECOPD) patients, 23 patients with stable COPD patients and 18 healthy control group, plasma 8-iso -PGF2a levels of plasma interferon-γ (Interferon-gamma, IFN-γ) and interleukin 4 (Interleukin-4, IL-4) level, the advantages of Th1/Th2 cells and is represented use ratio of IFN-γ/IL-4 to the state simultaneous detection of COPD patients FVC, FEV 1 . Data were expressed as mean ± standard deviation ((?) ± s) said, with SPSS10.0 statistical software analysis, the the AECOPD group with stable COPD, healthy control group with single-factor analysis of variance (one way ANOVA), COPD patients The relationship between before and after treatment paired t test, plasma 8-iso-PGF2a levels and lung function rank correlation analysis and t-test, P <0.05 was considered statistically significant. The results: (1) the AECOPD group with stable COPD group and healthy control group three groups plasma 8-iso-PGF2a levels were 6.84 ± 1.70ng/ml, 5.82 ± 1.72ng/ml, 4.64 ± 1.24 ng / ml, AECOPD group plasma 8-iso-PGF2a level than the stable period COPD group and healthy control group were significantly with increased (P <0.05, P <0.01), with stable COPD group plasma 8-iso-PGF2a level than the healthy control group significantly increased (P <0.05 ). (2) AECOPD smoking group plasma 8-iso-PGF2a level [(7.21 ± 1.67) ng / ml] than the non-smoking group (5.22 ± 1.37) ng / ml] significantly significantly increased (P <0.05); stable COPD smoking group plasma 8-iso-PGF2a level [(6.08 ± 1.82) ng / ml] compared with non-smoking group [(5.22 ± 1.37) ng / ml] increased, the difference was not statistically significant (P> 0.05); plasma of healthy control group smoking 8-iso-PGF2a levels [(5.33 ± 1.05) ng / ml] compared with non-smoking group [(4.07 ± 1.32) ng / ml] was significantly higher (P <0.05). 0.05). (4) According to the classification of COPD Global Initiative (GOLD) AECOPD group divided into three groups, the The three plasma 8-iso-PGF2a levels of: Ⅰ - Ⅱ grade 6.27 ± 1.38ng/ml Ⅲ grade 6.89 ± 1.92ng / ml, Ⅳ grade 8.5 ± 0.97ng/ml, the difference was not statistically significant (P> 0.05), rank correlation analysis, both a positive correlation (r = 0.419, P <0.05). (5) COPD patients with FEV1 after antibiotics before and after treatment were 1.09 ± 0.51 L, 1.13 ± 0.49L; FVC were 2.28 ± 0.94 L, 2.36 ± 1.01 L, the difference was not statistically significant (P> 0.05). (6) the AECOPD group of plasma IFN-γ, IL-4, of IFN-γ/IL-4 level is 924.87 ± 255.10pg/ml, 99.05 ± 18.63 pg / ml, 9.25 ± 1.32, respectively; stable COPD group were 666.87 ± 208.55pg/ml, 45.91 ± 16.16 pg / ml, 14.24 ± 2.02; healthy control group is 724.22 ± 170.46pg/ml 65.06 ± 13.21 pg / ml, 10.84 ± 1.81, AECOPD group plasma of IFN-γ, IL-4 and IFN-γ/IL-4 compared with stable COPD group and the healthy control group, the differences were statistically significant (P <0.05), with stable COPD group, IL-4, IFN-γ/IL-4 and Health control group, the difference was statistically significant (P <0.05), and stable COPD group, IFN-γ and the healthy control group, the difference was not statistically significant (P> 0.05). Conclusion: 1. Plasma 8-iso-PGF2a levels in acute exacerbation of COPD was significantly higher, there is a clear downward trend after antibiotic treatment for two weeks, determination of plasma 8-iso-PGF2a as early diagnosis AECOPD and prognostic indicators. 2. Plasma 8-iso-PGF2a level of smoking group than the non-smoking group increased, indicating that smoking can cause oxidative stress in the body, which led to the injury of the lung tissue. 3. According to different classification of COPD (GOLD classification), with the increase of patients with COPD classification level, the level of plasma 8-iso-PGF2a also gradually increased, significant positive correlation between plasma level of 8-iso-PGF2a to reflect the severity of COPD. 4. No significant changes in lung function in COPD patients before and after treatment, and therefore can not effectively predict acute exacerbation of COPD COPD patients before and after treatment, while the plasma level of 8-iso-PGF2a has changed significantly, indicating that plasma 8-iso-PGF2a can be used as an effective biochemical markers reflect acute exacerbation of COPD. 5. In COPD patients with different disease stage, there is the of with different Th1/Th2 advantage of state. Acute exacerbation of Th2 dominant state trends showed stable the period showed Th1 advantage status. Determination the plasma IFN-γ/IL-4 advantage of state indicators as reflected acute exacerbation of COPD patients.
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