稳定期COPD患者下呼吸道细菌定植对免疫功能、气道功能及炎症程度的影响

Effect of lower airway bacterial colonization on immune function,airway function and degree of inflammation in patients with stable COPD

目的:分析稳定期COPD患者下呼吸道细菌定植对免疫功能、气道功能及炎症程度的影响。方法:60例稳定期COPD患者经下呼吸道菌群检测分为定植组35例、未定植组25例,取同期在本院接受体检的健康人60例作为对照组。对比三组研究对象的免疫功能、小气道功能、炎症程度、气道重塑程度等差异。结果:未定植组外周血中CD34^+、CD11b的含量显著低于对照组,外周血中CD64、Th17、Treg的含量以及血清中C反应蛋白(CRP)、白介素-1β(IL-1β)、白介素-8(IL-8)、白介素-17(IL-17)、白介素-27(IL-27)、血管内皮生长因子(VEGF)、转化生长因子1(TGF-1)、神经生长因子(NGF)、碱性成纤维细胞生长因子(b-FGF)、机制金属蛋白酶-9(MMP-9)、基质金属蛋白酶抑制剂-1(TIMP-1)的含量显著高于对照组,气道功能指标25%肺活量最大呼气流速(FEF_(25))、50%肺活量最大呼气流速(FEF_(50))、75%肺活量最大呼气流速(FEF_(75))、25%~75%肺活量最大呼气流速(FEF_(25-75))水平显著低于对照组;定植组外周血中CD34^+、CD11b的含量显著低于未定植组及对照组,外周血中CD64、Th17、Treg的含量以及血清中CRP、IL-1β、IL-8、IL-17、IL-27、VEGF、TGF-1、NGF、b-FGF、MMP-9、TIMP-1的含量显著高于未定植组及对照组,气道功能指标FEF_(25)、FEF_(50)、FEF_(75)、FEF_(25-75)水平显著低于未定植组及对照组。结论:稳定期COPD患者下呼吸道细菌定植会造成患者免疫功能抑制、气道炎症反应及重塑,加速病情进展。

Objective： To analyze the effects of lower airway bacterial colonization on immune function, airway function and degree of inflammation in patients with stable COPD. Methods： A total of 60 patients with stable COPD were divided into colonization group （n = 35） and non-colonization group （n = 25） after lower airway flora detection, and 60 healthy subjects whoreceived physical examination in our hospital during the same period were selected as control group. Differences in immune function, small airway function, the degree of inflammation, the degree of airway remodeling and so on were compared among three groups. Results： CD34＋ and CDllb content in peripheral blood of non-colonization group were significantly lower than those of control group, CD64, Th17 and Treg content in peripheral blood as well as CRP, IL-1β, IL-8, IL-17, IL-27, VEGF, TGF-1, NGF, b-FGF, MMP-9 and TIMP-1 content in serum were significantly higher than those of control group, and the airway function indexes FEF25, FEF50, FEF75 and FEF25-75 levels were significantly lower than those of control group; CD34＋ and CDllb content in peripheral blood of colonization group were significantly lower than those of non-colonization group and control group, CD64, Th17 and Treg content in peripheral blood as well as CRP, IL-1β, IL-8, IL-17, IL-27, VEGF, TGF-1, NGF, b-FGF, MMP-9 and TIMP-1 content in serum were significantly higher than those of non-colonization group and control group, and the airway function indexes fEF25, FEF50, FEF75 and FEF25-75 levels were significantly lower than those of non-colonization group and control group.conclusions：Lower airway bacterial colonization in patients with stable COPD can cause immune suppression as well as airway inflammation and remodeling, and accelerate disease progression.