Objective To investigate the role of macrophage stimulating protein (MSP) in the pathogenesis of chronic obstructive pulmonary disease (COPD). Methods Ninety subjects were recruited from health examination center, outpatient or inpatient department in Affiliated Hospital of North Sichuan Medical College from July 2013 to December 2013. They were divided intoahealthy control group, a stable COPD group, and an acute exacerbation of COPD (AECOPD) group with 30 subjects in each group. The levels of MSP, interleukin-6 (IL-6), IL-8 and tumor necrosis factor-α (TNF-α) in the plasma of all subjects, as well as the levels of MSP in the induced sputum of the AECOPD and the stable COPD patients were assessed by enzyme-linked-immuno-sorbent assay. Results The concentrations of MSP, IL-6, IL-8 and TNF-α in the plasma of the patients with COPD were obviously higher than those of the healthy controls (P<0.05) while much higher in AECOPD patients than those in stable COPD patients (P<0.01).The concentration of MSP in the induced sputum of the patients with AECOPD was higher than that in the stable COPD patients (P<0.01). The concentrations of MSP in the serum and induced sputum as well as serum levels of IL-6, IL-8 and TNF-α in the patients with COPD were negatively correlated with the level of FEV1%pred. The concentrations of MSP in the serum and induced sputum in the COPD patients were positively correlated with the concentrations of IL-6, IL-8 and TNF-α. Conclusions The concentrations of serum and induced sputum MSP, and the serum concentrations of IL-6, IL-8 and TNF-α in COPD patients are related to the severity of the disease. MSP may play an important role in the pathogenesis of COPD. The mechanism might be mainly involved in the regulation of airway inflammation.
ObjectiveTo compare the difference of respiratory mechanics parameters between three different spontaneous breathing trials on COPD patients in weaning process. Methods17 patients with COPD underwent mechanical ventilation for at least 48 hours who were stable and ready for weaning were enrolled. All patients underwent three spontaneous breathing trials, ie, automatic tube compensation (ATC,compensation level 100%),low level pressure support ventilation (PSV,7 cm H2O) and T-piece. Each spontaneous breathing trials continued for 10 minutes. Before each autonomous respiration experiment ended,the respiratory mechanics parameters including high airway pressure (PIP),breathing rate (RR),blood oxygen saturation (SaO2),airway occlusion pressure at 0.1 second (P0.1),maximal inspiratory mouth pressure(Pimax) and rapid shallow breathing index (RSBI) were measured. Their differences between three spontaneous breathing trials were compared. Results12 patients successfully completed three different methods of spontaneous breathing test. Compared with the T-piece,P0.1,Pimax,RSBI and RR in the COPD patients using low level PSV and ATC were significantly decreased while VT and SaO2 were increased. The difference of each parameter in the low level PSV group and the ATC group had statistical significance compared with T-piece group (P<0.05). Compared with the low PSV group,P0.1,Pimax,RSBI and RR in ATC group were elevated while PIP,VT and SaO2 were reduced. The differences of P0.1,Pimax,RSBI,PIP and RR between two groups were statistically significant (P<0.05). ConclusionFor COPD patients in weaning process with spontaneous breathing trial,both low levels of PSV and ATC are better than T-piece,and the patients are more comfortable with ATC100% than PSV.