慢性阻塞性肺疾病长期机械通气患者T细胞亚群、补体及免疫球蛋白的变化

Change of T-lymphocyte subsets, complements and immunoglobulins in the COPD patients receiving long-term mechanical ventilation

目的研究慢性阻塞性肺疾病(COPD)长期机械通气患者T细胞亚群、补体及免疫球蛋白的变化规律。方法选择2003年3月至2005年2月解放军总医院老年病房收治的COPD长期机械通气患者42例,同时选择COPD稳定期的老年患者34例作为对照组。入选患者均进行免疫球蛋白IgA、IgG、IgM,补体C3、C4,及CD4、CD8的测定,并计算出CD4/CD8比值。结果COPD长期机械通气组与对照组比较,IgA、IgG、IgM均增高,补体C3、C4均降低,CD4降低、CD8升高,CD4/CD8降低。经统计学处理,除补体C3无统计学差异(P>0.05)外,其余各项指标均有显著差异(P<0.05)。结论COPD长期机械通气患者T细胞亚群、补体及免疫球蛋白均存在异常,呼吸机相关肺炎的发生可能与免疫功能异常有关。

Objective To investigate the change of the level of T-lymphocyte subsets （CD4, CD8 ）, complements（C3, C4 ） and immunoglobulins （IgA, IgG, IgM ） in the COPD patients receiving long-term mechanical ventilation. Methods Forty-two COPD patients receiving long-term mechanical ventilation and 34 stable COPD patients as control group were admitted in this hospital from Mar 2003 to Feb 2005. The level of T-lymphocyte subsets（ CD4, CD8 ）, complements（ C3, C4 ） and immunoglobulins （ IgA, IgG, IgM） were measured for all patients, and CD4/CD8 was calculated. Results IgA, IgG, IgM and CDs were elevated in long-term mechanical ventilation COPD group compared with control group, while C3, C4, CD4 and CD4/CD8 decreased. There were significant differences except for C3. Conclusion The level of T-lymphocyte subsets（ CD4, CD8 ）, complements（ C3 , C4 ） and immunoglobulins（ IgA, IgG, IgM）were significantly abnomal in COPD patients receiving long-term mechanical ventilation.