外周血白介素-17检测在气道慢性炎症性疾病诊断中的临床价值

Clinical values of interleukin-17 in the differentiation of asthma,chronic obstructive pulmonary disease and asthma chronic obstructive pulmonary disease overlap syndrome

目的探讨外周血CD4+T细胞亚群Th17代表性细胞因子IL-17在哮喘、慢性阻塞性肺疾病(COPD)以及哮喘COPD重叠综合征(ACOS)等气道慢性炎症性疾病鉴别诊断中的临床价值。方法收集哮喘患者26例、COPD患者33例及ACOS患者14例的血清、临床资料及实验室检查资料,检测哮喘、COPD、ACOS患者外周血IL-17等细胞因子、炎症介质、外周血白细胞分类计数、血清免疫球蛋白亚型以及肺通气功能,并进行组间比较。健康体检者69例作为对照。结果 Th17细胞因子IL-17在哮喘及ACOS组升高较COPD组更为明显(P<0.01)。调节性T细胞的主要细胞因子IL-10在哮喘患者中的水平明显低于COPD患者(P<0.05)。外周血炎症细胞比例、免疫球蛋白亚型在哮喘、COPD、ACOS鉴别诊断中具有一定参考价值。但肺通气功能指标对于以上三者的鉴别价值有限。哮喘及ACOS组患IL-17与肺通气功能指标呈负相关关系。结论 IL-17作为新型Th17细胞分泌的代表性细胞因子,在鉴别上述疾病中具有重要的参考价值。Th17/Treg细胞失衡可能是难治性哮喘的潜在发病机制。

Objective To evaluate the role oflnterleukin-17 （IL-17） in the differentiation of asthma, chronic obstructive pulmonary disease （COPD） and asthma COPD overlap syndrome （ACOS） . Methods A total of 26 patients of asthma, 33 patients of COPD and 14 patients of ACOS were selected according to corresponding diagnostic criteria. 69 of healthy person were as control. Cytokines including IL-17, IL-10, IL-6, IL-8, IL-1βand IL-2R, inflammatory mediators including CRP and PCT in serum, and subtypes of serum immunoglobulins were detected. Results of routine blood test were collected and analyzed. Pulmonary function were tested. Results IL-17 was increased very obviously in asthma and ACOS groups compared to COPD group （P〈0.01） , especially in ACOS group. While IL-10 in serum of asthma and ACOS groups was much lower than COPD group （P〈0.05）. The differentiation of white cells in peripheral blood, CRP, PCT and subtypes of serum immunoglobulins just showed weak difference between three groups. There is little value of pulmonary function in the differentiation of above diseases. Furthermore, IL-17 was negative correlation to the ventilation index of lung function from asthma and ACOS groups. Conclusion Our results suggested that IL-17 play a pivotal role in the pathogenesis of asthma and ACOS, and ThlT/Treg imbalance maybe involved in the refractory asthma.