关键词: 白细胞介素-6, 白细胞介素-17, 肿瘤坏死因子-α, C反应蛋白, 基质金属蛋白酶-9, 慢性阻塞性肺疾病, 骨质疏松症

Abstract: Objective To investigate the relationship between serum interleukin-6 (IL-6),interleukin-17 (IL-17),tumor necrosis factor-α (TNF-α),C-reactive protein (CRP),matrix metalloproteinase-9 (MMP-9) and osteoporosis (OP) in elderly patients with chronic obstructive pulmonary disease (COPD).Methods 135 elderly patients with COPD admitted to our hospital from April 2017 to January 2022 were retrospectively selected as the study object,according to whether the elderly COPD patients were complicated with OP,they were divided into OP group (75 cases) and non OP group (60 cases).The general data,25-hydroxyvitamin D [25 (OH) D] and other clinical biochemical indexes of the two groups were compared.The serum LEVELS of IL-6,IL-17,TNF-α,CRP and MMP-9 were compared between the two groups.Multivariate Logistic regression analysis was used to evaluate whether the above serum inflammatory factors were independent risk factors for OP in elderly COPD patients.Results The age of OP group was (73.87±9.70) years,which was higher than that of non-OP group (70.00±7.70) years,the difference was statistically significant (P<0.05); The proportion of women in OP group was 32.00%,higher than 16.67% in non OP group,the difference was statistically significant (P<0.05); The BMI of OP group was (21.05±3.21) kg/m2,which was lower than that of non OP group (24.95±2.93) kg/m²,the difference was statistically significant (P<0.05); The proportion of type 2 diabetes mellitus in the OP group was 17.33%,which was lower than 35.00% in the non-OP group,and the difference was statistically significant (P<0.05).Blood calcium and 25 (OH) D in OP group were (2.10±0.16) mmol/L and (15.83±4.02) ng/ml,respectively,lower than those in non-OP group (2.18±0.13) mmol/L and (17.96±5.00) ng/ml,and the difference was statistically significant (P<0.05).In OP group,IL-6,IL-17,TNF-α,CRP and MMP-9 were (76.85±9.26) ng/L,(27.18±4.52) pg/ml,(41.20±4.40) μg/L,(6.25±1.12) mg/L,(84.60±6.25) μg/L,respectively.It was higher than that in non-OP group [(52.91±7.07) ng/L,(10.50±3.50) pg/ml,(30.54±3.73) μg/L,(3.62±1.10) mg/L,(33.74±7.12) μg/L],and the difference was statistically significant (P<0.05).Multivariate Logistic regression analysis showed that age ,sex,IL-6 ,IL-17 ,TNF-α,CRP,MMP-9  were independent risk factors for OP in elderly patients with COPD (P<0.05),BMI,blood calcium,25 (OH) D were independent protective factors affecting OP in elderly patients with COPD (P<0.05).Conclusion IL-6,IL-17,TNF-α,CRP and MMP-9 are all abnormally high expression in serum of elderly patients with COPD complicated with OP,which are independent risk factors affecting elderly patients with COPD complicated with OP.

Key words: interleukin-6, interleukin-17, tumor necrosis factor-α, Creactive protein, matrix metalloproteinase-9, chronic obstructive pulmonary disease, osteoporosis