哮喘患者外周血调节性T细胞和Th1/Th2的变化及其与哮喘病情的关系

Changes of peripheral blood regulatory T cells and Th1/Th2 and their relations with asthma

目的探讨调节性T细胞（Treg）和Thl／Th2水平变化与哮喘病情的关系，初步揭示哮喘的发病机制。方法选取2014年12月～2015年12月在呼吸科收治的150例患者和健康职工50例，检测哮喘患者（急性期和缓解期）和健康职工外周血中的调节性T细胞和Th1／Th2的变化，通过SPSS22．0软件对数据进行分析。结果哮喘患者Treg显著低于健康对照组[（2．3±0．3）％】（拄9．043，P=O．0032）。急性期组患者显著低于缓解期组和对照组（t=3．289，P=0．0321，t=9．884，P=0．0011），重度患者【（0．8±0．3）％]低于轻度患者[（1．5±0．4）％]，且具有显著性差异（江8．945，P=0．0055），缓解期组与健康组比较，无显著性差异（t=0．487，P=0．3291）。Th1／Th2水平在哮喘急性患者组显著低于对照组（11．8±0．8）和哮喘缓解期组（8．5±0．6）（t=12．884，P=0．0008；t=13．289，P=0．0007），表明在哮喘发作期时，Th亚群出现明显的失衡。哮喘患者急性期组重度患者Th1／Th2水平（4．8±0．9）显著低于轻度患者（9．5±0．8），具有显著性差异（t=8．432，P=O．0041）。Spearman相关性分析显示Treg水平越低，哮喘患者病情越严重，呈负相关关系（r=-0．854，P=0．025）；Th1／Th2水平越低，哮喘患者的病情也越严重，呈负相关关系（r=-0．635，P=0．035）。且Treg水平和Th1／Th2水平呈正相关关系（r=0．889，P=0．013）。结论哮喘患者的发病机制可能是随着患者病情的加重，过敏原对机体的刺激程度加剧，进而引起外周血中Treg所占比例降低，免疫调节功能受到损伤，Th2细胞开始大量增殖活化，而Th1细胞则受到抑制，导致Th1／Th2表现失衡，从而引起哮喘的发作。

Objective To discuss the relations between changes of Treg and Thl/Th2 and asthma. Methods 150 pa- tients treated from December 2014 to December 2015 in our department and 50 healthy volunteers were selected to de- tect the changes of Treg and Thl/Th2 in peripheral blood of asthma patients （at acute stage and remission stage） and healthy subjects. The data was analyzed by SPSS22.0. Results The level of Trcg was significantly lower in the asthma patients than in the healthy control group [（2.3±0.3）%]（t=9.043, P=0.0032）, also significantly lower in the acute stage group than in the remission stage group and the healthy control group （t=3.289, P=0.0321, t=9.884, P=0.0011）, and was significantly lower in severe patients[（0.8±0.3）%] than in mild patients [（1.5±0.4）%]. There was no significant difference in Treg between the remission stage group and the healthy control group （t=0.487, P=0.3291）. The level of Thl/Th2 was significantly lower in the acute asthma patients （4.8±0.9） than in the healthy control group （11.8±0.8） and the remission stage group （8.5±0.6） （t=12.884, P=0.0008; t=13.289, P=0.0007）, indicating significant unbalance of Th subgroup in the onset period of asthma. In the acute stage group, the Th1/Th2 level of severe patients （4.8±0.9） was significantly lower than that in mild patients（9.5±0.8）, （t=8.432, P=0.0041）. Spearman correlation analysis showed a negative correlation that a lower level of Treg meant a severer condition of asthma （r=-0.854, P=0.025）, also a negative correlation that a lower level of Th1/Th2 meant a severer condition of asthma（r=-0.635, P=0.035）, and a positive correlation between level of Treg and level of Th1/Th2. Conclusion Pathogenesis of asthma is possible to be that along with the severity of dis- ease, the stimulation of allergen is aggravating, causing proportion decrease of Treg in peripheral blood and damage to the immune modulating function, leading to proliferation and activation of Th2 cells and inhibition of Thl cells, result- ing in unbalance of Thl/Th2 and causing onset of asthma.