慢性阻塞性肺疾病患者辅助性T细胞17/调节性T细胞变化及其与肺功能的相关性研究

Change of Th17/Treg Cells and Its Correlation With Pulmonary Function of Patients With Chronic Obstructive Pulmonary Disease

目的观察慢性阻塞性肺疾病(COPD)患者辅助性T细胞17(Th17细胞)/调节性T细胞(Treg细胞)变化,探讨其与肺功能的相关性。方法选取2013年9月—2015年9月四川省成都市西区医院收治的老年COPD稳定期患者36例作为稳定期组,COPD急性加重期患者29例作为急性加重期组;另选取同期在本院体检健康者50例作为对照组,其中吸烟者22例作为吸烟对照组,不吸烟者28例作为正常对照组。比较4组受试者外周血Th17细胞分数、Treg细胞分数、Th17细胞/Treg细胞比值,血清IL-17、IL-10水平及肺功能指标〔第1秒用力呼气容积占预计值百分比(FEV1%)、用力肺活量占预计值百分比(FVC%)及第1秒用力呼气容积与用力肺活量比值(FEV1/FVC)〕,并分析外周血Th17细胞分数、Treg细胞分数及Th17细胞/Treg细胞比值与肺功能指标的相关性。结果急性加重期组和稳定期组患者外周血Th17细胞分数、Th17细胞/Treg细胞比值及血清IL-17水平高于吸烟对照组和正常对照组,外周血Treg细胞分数及血清IL-10水平低于吸烟对照组和正常对照组(P<0.05);急性加重期组患者外周血Th17细胞分数、Th17细胞/Treg细胞比值及血清IL-17水平高于稳定期组,外周血Treg细胞分数及血清IL-10水平低于稳定期组(P<0.05);吸烟对照组受试者外周血Th17细胞分数、Th17细胞/Treg细胞比值高于正常对照组(P<0.05)。4组受试者FVC%比较,差异无统计学意义(P>0.05);急性加重期组和稳定期组患者FEV1%、FEV1/FVC低于吸烟对照组和正常对照组,急性加重期组患者FEV1%、FEV1/FVC低于稳定期组(P<0.05)。Pearson相关性分析结果显示,外周血Th17细胞分数与FEV1、FEV1%/FVC呈负相关(r值分别为-0.736、-0.694,P<0.05),Th17/Treg细胞比值与FEV1、FVC%、FEV1%/FVC呈负相关(r值分别为-0.892、-0.222、-0.748,P<0.01),而外周血Treg细胞分数与FEV1、FVC%、FEV1%/FVC呈正相关(r值分别为0.837、0.368、0.822,P<0.01)。结论 COPD患者存在Th17/Treg细胞失衡,而Th17/Treg细胞失衡与吸烟、COPD病情变化及肺功能损伤等密切相关。

Objective To observe the change of Th17 / Treg cells of patients with chronic obstructive pulmonary disease （COPD）,to investigate its correlation with pulmonary function. Methods From September 2013 to September 2015 in Chengdu Western Hospital,a total of 36 patients with stable COPD were selected as A group,29 patients with acute exacerbation of COPD were selected as B group,22 smoking healthy people admitted to this hospital for physical examination were selected as C group, and 28 non - smoking healthy people admitted to this hospital for physical examination were selected as D group. Peripheral blood Th17 cell percentage,Treg cell percentage,Th17 / Treg cell ratio,serum levels of IL-17 and IL-10,and index of pulmonary function（FEV1% ,FVC% and FEV1 / FVC） were compared among the four groups,and the correlations between peripheral blood Th17 cell percentage,Treg cell percentage,Th17 / Treg cell ratio and index of pulmonary function were analyzed. Results Peripheral blood Th17 cell percentage,Th17 / Treg cell ratio and serum IL-17 level of A group and B group were statistically significantly higher than those of C group and D group,while peripheral blood Treg cell percentage and serum IL-10 level of A group and B group were statistically significantly lower than those of C group and D group（ P ﹤ 0. 05）;peripheral blood Th17 cell percentage,Th17 / Treg cell ratio and serum IL-17 level of B group were statistically significantly higher than those of A group,while peripheral blood Treg cell percentage and serum IL-10 level of B group were statistically＆nbsp;significantly lower than those of A group（P ﹤ 0. 05）;peripheral blood Th17 cell percentage and Th17 / Treg cell ratio of C group were statistically significantly higher than those of D group（ P ﹤ 0. 05）. No statistically significant differences of FVC% was found among the four groups（P ﹥ 0. 05）;FEV1% and FEV1 / FVC of A group and B group were statistically significantly lower than those of C group and D group,FEV1% and FEV1 / FVC of B group were statistically significantly lower than those of A group （P ﹤ 0. 05 ）. Pearson correlation analysis showed that,peripheral blood Th17 cell percentage was respectively negatively correlated with FEV1% and FEV1 / FVC（r = - 0. 736, - 0. 694,P ﹤ 0. 01）,Th17 / Treg cell ratio was respectively negatively correlated with FEV1% ,FVC% and FEV1 / FVC（r = - 0. 892, - 0. 222, - 0. 748,P ﹤ 0. 01）,while peripheral blood Treg cell percentage was respectively positively correlated with FEV1% ,FVC% and FEV1 / FVC（r = 0. 837,0. 368,0. 822,P ﹤0. 01）. Conclusion Th17 / Treg cells imbalance widely exists in patients with COPD,and it is correlated with smoking,disease evolution of COPD and lung function injury.