慢性阻塞性肺疾病患者病毒感染状况及与T淋巴细胞免疫功能的关系

Effect of virus infections on T lymphocyte subsets in patients with chronic obstructive pulmonary disease

目的探讨常见病毒感染与慢性阻塞性肺疾病(COPD)的关系及其对T淋巴细胞亚群的影响。方法选择268例COPD急性加重期患者(A组)、92例COPD稳定期患者(B组)、76例健康体检者(C组)检测呼吸道合胞病毒(RSA)、单纯疱疹病毒(HSV)、腺病毒(ADV)、巨细胞病毒(CMV)的特异性抗体IgM、IgG,依据结果对A组中IgM阳性病例(D组)检测T淋巴细胞亚群CD3+、CD4+、CD8+,并分别与B组、C组比较。结果 268例A组患者共检测出IgM阳性55例(20.5%),高于B组(3.3%)及C组(3.9%)。A组患者IgG阳性率(74.2%)与B组(70.7%)比较,差异无统计学意义,但A、B两组分别与C组(31.6%)比较,差异有统计学意义。B组患者的CD3+、CD4+、CD4+/CD8+均较C组低,而CD8+升高,2组相比有统计学差异;D组与B组相比,CD3+无明显变化,但CD4+、CD4+/CD8+下降更显著,CD8+进一步升高。结论病毒感染是COPD急性加重期的重要因素,并引起COPD患者T淋巴细胞亚群功能紊乱。

Objective To investigate the relationship between virus infections and chronic obstructive pulmonary disease（COPD）,and to explore the effect of virus infections on T lymphocyte subsets in patients with chronic obstructive pulmonary disease.Methods Serum samples from 268 patients with acute exacerbation of COPD（group A）,92 patients with stable COPD（group B）,and 76 healthy subjects（group C） were tested for specific IgM and IgG antibodies for viruses.According to the above detection,serum from patients with positive IgM in group A（group D）,group B and group C were tested and compared for T lymphocyte subsets.Results The positive rate of IgM was significantly higher in group A（20.5%） compared to group B（3.3%） and group C（3.9%）.There were no significant differences in the positive rates of IgG between group A（74.2%） and group B（70.7%）,but the positive rates of IgG in the two groups were higher than in group C（31.6%）.In group B,expressions of CD3＋,CD4＋,CD4＋/CD8＋ were significantly lower than in group C,but CD8＋ was higher.There was no difference in CD3＋ expression in group B in contrast to group D.CD4＋,CD4＋/CD8＋ were lower and CD8＋ were higher in group D than group B.Conclusion Viral infection is common and important in COPD,and it may aggravate T lymphocyte subsets function.