外周血CD4^＋CD25^＋调节性T细胞及C反应蛋白在慢性阻塞性肺疾病急性加重期的变化及临床意义

Clinical significance of the level of CD4^＋CD25^＋ regulatory T cells and C-reactive protein in patients with acute exacerbation of chronic obstructive pulmonary disease

目的探讨COPD急性加重期患者外周血中CD4^＋CD25^＋调节性T细胞及CRP水平的变化及意义。方法以36例COPD急性加重期患者（COPD组）和36例COPD稳定期患者（对照组一）及36例健康人（对照组二）作为研究对象，采用流式细胞技术检测三组外周血中CD4^＋CD25^＋调节性T细胞的表达水平，并常规检测血清CRP水平。结果COPD组外周血中CD4^＋CD25^＋占CD4^＋T细胞的百分比为（2．56±1．83）％，明显低于对照组一和对照组二（P均〈0．01）；COPD组CRP水平为（55．7±14．8）mg／L，明显高于对照组一和对照组二（P均〈0．01）。CD4^＋CD25^＋调节性T细胞表达水平与CRP水平呈负相关（r=-0．312，P〈0．05）。结论CD4^＋CD25^＋调节性T细胞比例减少导致COPD急性加重期患者细胞免疫失调，CRP参与了炎性反应激活过程，可能为COPD急性加重期免疫治疗提供理论依据。

Objective To study the changes and significance of CD4^＋CD25^＋ regulatory T cells and C-reactive protein （CRP） in patients with acute exacerbation of chronic obstructive pulmonary disease （COPD）. Methods Flow cytometry was used to detect the frequency of CD4^＋CD25^＋ regulatory T cells in peripheral blood from 36 patients with acute exacerbation of COPD （ COPD group） and 36 patients with clinical stability of COPD （control group one ）and 36 normal individuals （control group two）. The level of CRP was detected routinely. Results The ratio of CD4^＋CD25^＋ regulatory T cells number in peripheral blood of COPD group to the total number of CD4^＋ T cell was （2.56 ± 1.83 ）%, and it was significanlly decreased compared to the other two groups （P all 〈 0.01 ）. The level of CRP in COPD group was markedly higher than that in the other two groups （Pall 〈 0.01 ）. The level of CD4^＋CD25^＋ regulatory T cells in patients with acute exacerbation of COPD had negative relation with CRP. Condusions CD4^＋CD25^＋ regulatory T cells participate in inflammatory response. The proportion of CD4^＋CD25^＋ regulatory T ceils decreases in patients with acute exacerbation of COPD, and it may result in maladjustment ofcytoimmunity.