慢性阻塞性肺疾病患者外周血T淋巴细胞的表达及其与肺功能的关系

Expression of peripheral blood T lymphocytes and its relationship with lung function among patients with chronic obstructive pulmonary disease

目的探讨慢性阻塞性肺疾病(COPD)患者外周血T淋巴细胞的表达及与肺功能的关系。方法检测COPD缓解期患者60例(COPD缓解期组)、慢性阻塞性肺疾病急性加重期(AECOPD)患者60例(AECOPD组)和体检健康者50例(对照组)的外周血CD3+、CD4+、CD8+及CD4+/CD8+T淋巴细胞水平。COPD缓解期组在治疗前进行肺功能检查。结果 AECOPD组及COPD缓解期组血清CD3+、CD4+、CD4+/CD8+T淋巴细胞水平均低于对照组(P<0.05),CD8+T淋巴细胞水平高于对照组(P<0.05)。COPD缓解期组血清CD3+、CD4+、CD4+/CD8+T淋巴细胞水平高于AECOPD组,CD8+T淋巴细胞水平低于AECOPD组(P<0.05)。COPD缓解期组患者CD4+T淋巴细胞水平与第一秒用力呼气容积(FEV1)及用力肺活量(FVC)呈显著正相关(P<0.05),CD4+/CD8+T淋巴细胞水平与FEV1及FVC呈正相关(P<0.05),CD8+T淋巴细胞水平与FEV1及FVC呈负相关(P<0.05),CD3+T淋巴细胞水平与FEV1和FVC无统计学相关性(P>0.05)。结论COPD患者存在细胞免疫功能障碍,且随着病情的加重和肺功能的降低其免疫功能呈进行性减退。

Objective To investigate the expression of peripheral blood T lymphocytes and its relationship with lung function among patients with chronic obstructive pulmonary disease（COPD）.Methods The levels of CD3^＋,CD4^＋,CD8^＋and CD4^＋/CD8^＋T lymphocytes were detected among 60 patients with stable COPD（stable COPD group）,60 patients with acute exacerbation of chronic obstructive pulmonary disease（AECOPD,AECOPD group） and 60 normal controls.Lung function test was performed in the stable COPD group before treatment. Results The serum levels of CD3^＋,CD4^＋and CD4^＋/CD8^＋T lymphocytes were lower while the level of CD8^＋T lymphocytes was higher in the AECOPD group and stable COPD group compared with the controls（P〈0.01）.The serum levels of CD3^＋,CD4^＋and CD4^＋/CD8^＋T lymphocytes were higher while the level of CD8^＋T lymphocytes was lower in the stable COPD group compared with AECOPD group （P〈0.05）.In the stable COPD group,the level of CD4^＋T lymphocytes positively correlated with forced expiratory volume in one second （FEV1） and forced vital capacity（FVC） significantly（P〈0.01）,the level of CD4^＋/CD8^＋T lymphocytes positively correlated with FEV1 and FVC（P〈0.05）,the level of CD8^＋T lymphocytes negatively correlated with FEV1 and FVC（P〈0.05）,and the level of CD3^＋T lymphocytes showed no correlation with FEV1 and FVC（ P〉0.05） .Conclusion Cellular immune dysfunction can be observed in COPD patients,which presents a progressive loss of immune function with the increasing severity of the disease and poorer lung function.