COPD患者Th17细胞和Treg细胞介导的免疫应答变化及免疫失衡与肺功能的关系研究

Relationship of immune response and immune imbalance mediated by Th17 cells and Treg cells with pulmonary function in COPD patients

目的:探讨慢性阻塞性肺疾病(COPD)患者外周血Th17细胞和调节性T细胞(Treg)及其介导的免疫应答变化与患者肺功能的关系。方法:选取本院呼吸内科收治的90例COPD患者(COPD组)和同期年龄、性别基本匹配的45例健康体检对象作为对照组,并根据COPD病情进行亚组分析,分别测定各组研究对象肺功能指标、Th17细胞、Treg细胞及血清炎症因子水平。结果:在COPD患者间,随着病情加重,FEV1%、FVC%、FEV1/FVC比值中度COPD组<重度COPD组<极重度组(P<0.05);在COPD患者间,随着病情加重,外周血中Th17细胞、Th17/Treg比值中度COPD组<重度COPD组<极重度组(P<0.05),外周血Treg细胞比值中度COPD组>重度COPD组>极重度组(P<0.05),且外周血Th17细胞、Treg细胞相关细胞因子变化具有一致性;COPD患者的肺功能指标FEV1%、FVC%、FEV1/FVC与外周血中Th17细胞、Th17/Treg比值呈显著的负相关关系(P<0.05),肺功能指标FEV1%、FVC%、FEV1/FVC与外周血Treg比值呈显著的正相关关系(P<0.05)。结论:COPD外周血Th17/Treg比值与患者肺功能下降具有显著的相关性。

Objective： To investigate the relationship of the immune response and immune imbalance mediated by Th17 cells and Treg cells with pulmonary function in chronic obstructive pulmonary disease（ COPD） patients. Methods： 90 COPD patients and 45 healthy volunteers with matched age and sex were selected. The COPD patients were divided into 2 groups according to the patient ＇s condition. 45 healthy volunteers were collected as the control group. The lung function,Th17 cells,Treg cells and serum levels of inflammatory cytokines were detected and compared. Results： In COPD patients,the FEV1%,FVC%,FEV1 / FVC,Th17,Th17 / Treg and inflammatory cytokines had increased in an order of moderate COPD,severe COPD and very severe COPD（ P〈0. 05）. Treg had increased in an order of very severe COPD,severe COPD and moderate COPD（ P〈0. 05）. FEV1%,FVC% and FEV1 / FVC were negatively correlated with Th17 and Th17 / Treg（ P 0. 05）. FEV1%,FVC% and FEV1 / FVC were positively correlated with Treg（ P 0. 05）. Conclusion： Th17 / Treg in peripheral blood of COPD patients is significantly correlated with the decrease of pulmonary function.