支气管哮喘并肺部感染者外周血Th9和Treg细胞及细胞因子改变的临床价值分析

Changes of Th9,Treg cells and cytokines in peripheral blood of patients with bronchial asthma complicated by lung infection and analysis of their clinical value

目的探讨支气管哮喘并肺部感染者外周血辅助型T细胞9(Th9)和调节型T细胞(Treg)及细胞因子改变的临床价值。方法选择保定市第五医院呼吸内科2018年2月-2020年2月收治的支气管哮喘并肺部感染患者68例作为研究组,选择同期收治的支气管哮喘未发生肺部感染患者40例作为对照组,比较两组Th9、Treg、白介素-9(IL-9)、转化生长因子-β(TGF-β)及肺功能指标第1秒用力呼气容积(FEV1)、FEV1/用力肺活量(FVC)水平。将研究组患者根据哮喘分期、肺部感染严重程度进一步分组,比较不同亚组Th9、Treg、IL-9、TGF-β水平;Pearson法分析Th9、Treg、IL-9、TGF-β与FEV1、FEV1/FVC相关性。结果研究组Th9、Treg细胞比例、血清IL-9、TGF-β表达水平高于对照组,肺功能指标FEV1、FEV1/FVC低于对照组,差异有统计学意义(P<0.05);急性发作期组Th9、Treg细胞比例、血清IL-9、TGF-β表达水平高于慢性持续组及临床缓解期组,慢性持续期组Th9、Treg细胞比例、血清IL-9、TGF-β表达水平高于临床缓解期组,差异有统计学意义(P<0.05);随着感染严重程度的加重,患者Th9、Treg细胞比例、血清IL-9、TGF-β表达水平不断增加,差异有统计学意义(P<0.05);研究组患者Th9、Treg细胞比例、血清IL-9、TGF-β表达水平与肺功能指标FEV1、FEV1/FVC成负相关关系(P<0.05)。结论由Th9、Treg免疫细胞介导的免疫反应可能参与了支气管哮喘患者的肺部感染进程,可进一步研究其作为免疫治疗靶点的可能性。

Objective To explore the changes and clinical value of help T cell 9(Th9)and T regular cell(Treg)cells and cytokines in peripheral blood of patients with bronchial asthma and lung infection.Methods 68 patients with bronchial asthma and lung infections admitted to the Department of Respiratory Medicine,Baoding Fifth Hospital from February 2018 to February 2020 were selected as the study group,and 40 patients with bronchial asthma who did not develop pulmonary infection during the same period were selected as the control group.Th9,Treg,interleukin-9(IL-9),transforming growth factor-β(TGF-β)and lung function indexes forced expiratory volume in the first second(FEV1),FEV1/forced vital capacity(FVC)were compared between the two groups.The patients in the study group were further grouped according to the stage of asthma and the severity of lung infection,and the levels of Th9,Treg,IL-9,and TGF-β in different subgroups were compared.Pearson method was used to analyze Th9,Treg,IL-9,TGF-β,and FEV1,FEV1/FVC correlation.Results The proportion of Th9 and Treg cells,the expression levels of serum IL-9 and TGF-β in the study group were higher than those in the control group,and the lung function indexes FEV1,FEV1/FVC were lower than those in the control group(P<0.05).The proportion of Th9 and Treg cells in the acute attack group,serum IL-9,TGF-β expression levels were higher than those in chronic persistent group and clinical remission group;the ratio of Th9,Treg cells,serum IL-9,TGF-β expression levels in chronic persistent group were higher than those in clinical remission group(P<0.05).As the severity of infection increased,the proportion of patients’ Th9,Treg cells,serum IL-9,and TGF-β expression levels continued to increase,and the difference was statistically significant(P<0.05).Patients in the study group had Th9,Treg cells the ratio,serum IL-9 and TGF-β expression levels were negatively correlated with lung function indexes FEV1,FEV1/FVC(P<0.05).Conclusion The immune response mediated by Th9 and Treg immune cells participates in the process of lung infection in patients with bronchial asthma,and it was expected to be a target for immunotherapy and deserves further study.