哮喘患者T细胞亚群数量与FEV_1变化的相关性及意义(英文)

Correlation and significance of changes of T lymphocyte subsets and FEV1 in asthmatic patients

目的探讨哮喘患者T细胞亚群数量及与肺通气功能指标(FEV1)变化的相关性及其临床意义。方法用流式细胞仪测定并对比分析22例哮喘发作期、22例咳嗽变异型哮喘患者及25例健康正常者外周血T细胞亚群(CD4+、CD8+)与肺通气功能指标(FEV1)。结果CD4+:哮喘发作期组与咳嗽变异型哮喘组及正常对照组比较差异无显著性(P>0.05),但咳嗽变异型哮喘组低于正常对照组(P<0.01);CD8+:哮喘发作期组低于咳嗽变异型哮喘组及正常对照组(P<0.01),差异均有显著性。CD4+/CD8+比值:哮喘发作期组高于咳嗽变异型及正常对照组(P<0.01),咳嗽变异型哮喘组亦高于正常对照组(P<0.01),差异均有显著性。1s用力呼气容积(FEV1)与CD8+呈显著正相关(r=0.57,P<0.01)与CD4+/CD8+比值呈显著负相关(r=-0.62,P<0.01)。结论哮喘患者CD8+阳性细胞百分率下降,CD4+/CD8+细胞比值失衡,患者体内细胞免疫功能异常,可能是哮喘容易反复发作、导致肺通气功能进一步减退的原因。在治疗哮喘病过程中,除对症处理外,应该配合调节细胞免疫功能的药物,以改善肺通气功能。

Objective: To investigate the relationship between the changes of T lymphocyte subsets and ventilatory function (FEV1) in asthmatic patients and its clinical significance. Methods: Flowcytometry was used to compare and analyze the T lymphocyte subsets (CD4+, CD8+) in the peripheral blood from 22 acute attack asthmatic patients, 22 asthmatic patients with cough variant asthma and 25 healthy subjects. Indexes of ventilatory function (FEV1) were recorded. Results: There was no significant difference between acute attack patients and cough variant asthma in the percentage of CD4+ (P >0.05), as well as the normal control group (P >0.05), but the percentage of CD4+ was significantly lower in patients with cough variant asthma than that in the normal control group (P <0.01). The percentage of CD8+ was significantly lower in acute attack patients than that in the normal control group as well as that in the patients with cough variant asthma (P <0.01); the percentage of CD8+ was significantly lower in cough variant asthma than in the normal control group (P <0.01). The ratio of CD4+/CD8+ in acute attack asthmatic patients was significantly higher than that in the patients with cough variant asthma and the normal control group (P <0.01). And the ratio of CD4+/CD8+ in the patients with cough variant asthma was higher than that in the normal control group (P <0.01). The correlation analysis showed that the value of FEV1 (forced expiratory volume in 1 second) had significantly positive relation with CD8+ (r=0.57, P <0.01), but had a significantly negative correlation with the ratio of CD4+/CD8+ (r=-0.62, P <0.01). Conclusions: The decrease of CD8+ cells, the imbalance in the ratio of CD4+/CD8+ and the disturbance of the immune system in asthmatic patients may result in the recurrence of asthma and further deterioration of ventilatory functions. Therefore, to improve their ventilatory functions, immunity-regulating drugs must be used in addition to routine therapy.