慢性阻塞性肺疾病急性加重期患者外周血中树突状细胞亚群的水平变化及其意义

Relationship between peripheral blood dendritic cell subsets and acute exacerbation of chronic obstructive pulmonary disease

目的探讨慢性阻塞性肺疾病急性加重期(AECOPD)患者外周血中树突状细胞(DC)亚群的水平变化及其意义。方法选取该院呼吸内科收治的120例AECOPD患者、门诊复查的60例COPD稳定期(SCOPD)患者和门诊体检的60例健康人作为研究对象,所选研究对象年龄、性别基本相匹配。采取流式细胞术检测各组研究对象外周血DC亚群、测定肺功能指标及相关炎性因子水平,并分析DC亚群与AECOPD患者肺功能指标的关系。结果 AECOPD患者的第1秒用力呼气容积(FEV1%)、FEV1/FVC(%)值比较发现慢性阻塞性肺疾病全球倡议(GOLD)Ⅰ组>GOLDⅡ组>GOLDⅢ~Ⅳ组,且差异有统计学意义(P<0.05)。AECOPD及SCOPD患者的C-反应蛋白(CRP)、血沉(ESR)、白细胞计数(WBC)值、mDCs、pDCs细胞比例均高于正常对照组,而CD123+、CD11+细胞比例均低于正常对照组,均差异有统计学意义;AECOPD患者的CRP、ESR、WBC值及mDCs、pDCs细胞比例组间比较发现GOLDⅠ组<GOLDⅡ组<GOLDⅢ~Ⅳ组,且均差异有统计学意义(P<0.05)。而CD123+、CD11+细胞比例组间比较为GOLDⅠ组>GOLDⅡ组>GOLDⅢ~Ⅳ组,均差异有统计学意义(P<0.05)。AECOPD患者的FEV1%值与mDCs、pDCs细胞比例值呈显著的负相关(P<0.05);AECOPD患者的FEV1%值与CD123+、CD11+细胞比例值呈显著的正相关(P<0.05)。结论 AECOPD患者的DC细胞亚群水平显著的改变,并且与患者的疾病严重程度具有一定的关系,提示DC细胞亚群与患者炎性反应过程有关。

Objective To investigate the changes of the levels of dendritic cells( DC) and its significance in the peripheral blood of patients with acute exacerbation of chronic obstructive pulmonary disease(AECOPD). Methods Outpatients and inpatients in our hospital were taken as the research objects. 120 patients of AECOPD,60 COPD patients and 60 healthy control people were observed. DC and DC,and the relationship between AECOPD and lung function index were analyzed. Results FEV1,FEV1/FVC( %) values of AECOPD patients were found to have statistically significant difference(P <0.05) in the GOLD Ⅰ group > GOLD Ⅱ group > GOLD Ⅲ~Ⅳgroup. The ESR,WBC and CRP values of AECOPD patients were found to have statistically significant difference( < GOLD) in the GOLD group < GOLD. The mDCs and pDCs cells of AECOPD patients were compared with that of GOLD I group < GOLD Ⅱ group <GOLD Ⅲ~Ⅳ group,CD123 +,< GOLD,CD11+,> GOLD,and the difference was statistically significant(P<0. 05). The FEV1 %values of AECOPD patients were negatively correlated with mDCs and pDCs cells(P <0.05),and the FEV1% values of AECOPD patients were significantly positive correlated with CD123 + and CD11+ cells(P<0.05). Conclusion The level of DC cell subsets in patients with AECOPD was significantly changed,and it has a certain relationship with the severity of the disease,which suggests that the DC lymphocyte subsets are related to the inflammatory reaction process.