T淋巴细胞亚群、PCT和FeNO在哮喘-慢阻肺重叠综合征患者中的临床应用价值

The clinical application value of T lymphocyte subsets,PCT and FeNO in patients with Asthma-COPD overlap syndrome

目的:观察T淋巴细胞亚群、血清降钙素原(Procalcitonin,PCT)和呼出气一氧化氮(Fractional exhaled nitric oxide, FeNO)在哮喘-慢阻肺重叠综合征(Asthma-COPD overlay syndrome,ACOS)患者中的临床应用价值。方法:哮喘-慢性阻塞性肺疾病重叠综合征患者20例,入院为ACOS急性加重期,出院2月后为ACOS稳定期,采用流式细胞仪检测T淋巴细胞亚群,测血清PCT,测定肺功能和FeNO。结果:与ACOS稳定期相比,ACOS患者急性加重期时肺功能差,FEV1/FVC和PaO_(2)明显下降,PaCO_(2)明显升高,PCT、C反应蛋白和FeNO明显升高,差异均有统计学意义(P均<0.05)。与ACOS稳定期相比,ACOS患者急性加重期时CD3^(+)、CD4^(+)、CD4^(+)/CD8^(+)及NK细胞明显降低,CD8^(+)细胞明显升高,差异均有统计学意义(P<0.05)。结论:对ACOS患者进行PCT、T淋巴细胞亚群和FeNO的监测有助于患者病情评估和疗效观察。

Objective:To observe the clinical application value of T lymphocyte subsets,PCT and FeNO in patients with Asthma-COPD overlap syndrome.Methods:Twenty patients with ACOS were admitted in the acute exacerbation stage of ACOS and discharged from the hospital for the stable stage of ACOS 2 months later.T-lymphocyte subsets were detected by flow cytometry,serum PCT was measured,and lung function and FeNO were measured.Results:Compared with the stable period of ACOS,ACOS patients in the acute exacerbation period had poor lung function,FEV1/FVC and PaO2 were significantly decreased,PaCO_(2) was significantly increased,and procalcitonin PCT,CRP and FeNO were significantly increased,with statistical significance(P<0.05).Compared with the stable period of ACOS,CD3^(+),CD4^(+),CD4^(+)/CD8^(+)and NK cells in the acute exacerbation period of ACOS patients were significantly lower,and CD8^(+)cells were significantly higher,the differences were statistical significance(P<0.05).Conclusion:The monitoring of PCT,T lymphocyte subsets and FENO in ACOS patients is helpful for the evaluation of the disease and observation of the curative effect.