COPD患者肺泡灌洗液中免疫球蛋白、淋巴细胞亚群及iNOS的表达及相关性

Expression and Correlation of Immunoglobulin,Lymphocyte Subsets and iNOS in BALF of COPD Patients

目的:检测慢性阻塞性肺疾病(COPD)患者肺泡灌洗液中免疫球蛋白(Ig)、淋巴细胞亚群及诱导型一氧化氮合成酶(iNOS)的水平,了解各组的免疫状态,分析与iNOS的相关性。方法:收集160例COPD患者,根据GOLD临床分为A组、B组、C组、D组,每组40例,选取同期健康者40例作为对照组。用免疫比浊法检测各组Ig表达;流式细胞术检测淋巴细胞亚群的水平;RT-PCR测定各组iNOS水平;EILSA检测法测定各组NO、IL-6水平。结果:(1)四组COPD患者中IgM、IgA水平与对照组比较无明显差异,两两比较差异无统计学意义(P>0.05)。除外A组,B组、C组、D组患者IgG的检测水平均高于对照组,比较差异具有统计学意义(P<0.05)。(2)四组CD4^(+)T细胞计数和CD4^(+)T/CD8^(+)T比值均显著低于对照组,随着分组级别越高,显著性更明显,差异具统计学意义(P<0.05)。四组患者CD8^(+)T计数水平较对照组明显升高,二者比较差异具有统计学意义(P<0.05)。B组、C组、D组与对照组、A组CD3^(-)CD19^(+)比较明显升高,差异均有统计学意义(均P<0.05)。B组、C组、D组与A组、对照组NK细胞比较均明显下降,差异均有统计学意义(均P<0.05)。(3)除A组外,其他三组iNOS水平均较对照组明显升高,两两比较差异具有统计学意义(均P<0.05)。B组、C组、D组的NO和IL-6水平与对照组比较明显升高,两两比较均有统计学意义(均P<0.05)。(4)iNOS与CD4^(+)T、CD4^(+)T/CD8^(+)T、NK细胞水平呈负相关关系,iNOS与CD8^(+)T、IgG水平存在一定正相关关系,iNOS与B淋巴细胞水平无明显相关性。结论:不同阶段COPD患者免疫状况有差异,分组级别越高iNOS表达越明显,可作为评估炎症程度指标。

Objective:To detect the levels of immunoglobulin(Ig),lymphocyte subsets and inducible nitric oxide synthase(iNOS)in the alveolar lavage fluid of patients with chronic obstructive pulmonary disease(COPD)and understand the immune status of each group analyze the correlation with iNOS.Methods:A total of 160 COPD patients were collected and divided into groups A,B,C,and D according to GOLD clinical groupings.40 patients without COPD served as the control group.Immunoturbidimetric method was used to detect the expression of Ig in each group;flow cytometry was used to detect the level of lymphocyte subsets;RT-PCR was used to determine the level of iNOS in each group;the EILSA method was used to determine the levels of NO and IL-6 in each group.Results:(1)The measured levels of IgM and IgA in the four groups of COPD patients were not significantly different from those in the control group,and there was no statistically significant difference in pairwise comparison(P>0.05).Except for group A,the detection levels of IgG in group B,C,and D were higher than those in the control group,which was statistically significant(P<0.05).(2)The CD4^(+)T cell counts and CD4^(+)T/CD8^(+)T ratios of the four groups were significantly lower than those of the control group.The higher the grouping level,the more significant the difference,and the difference was statistically significant(P<0.05).The CD8^(+)T count levels of the four groups of patients were significantly higher than those of the control group,and the difference between the two was statistically significant(P<0.05).The CD3^(-)CD19^(+)of group B,group C,and group D was significantly higher than that of control group and group A,and the difference was statistically significant(P<0.05).The NK cells of group B,group C,and group D were significantly decreased compared with group A and control group,and the difference was statistically significant(P<0.05).(3)Except for group A,the iNOS levels of the other three groups were significantly higher than those of the control group,and the pairwise comparison was statistically significant(P<0.05).The levels of NO and IL-6 in groups B,C,and D were significantly higher than those in the control group,and both comparisons were statistically significant(P<0.05).(4)iNOS has a negative correlation with CD4^(+)T,CD4^(+)T/CD8^(+)T,and NK cell levels,iNOS has a positive correlation with CD8^(+)T,IgG levels,and iNOS has no obvious correlation with B lymphocyte levels.Conclusion:There are differences in the immune status of COPD patients at different stages.The higher the group level,the more obvious the expression of iNOS,which can be used as an index to assess the degree of inflammation.