血清辅助性T淋巴细胞因子水平变化与COPD患者肺功能的关系

Relationship between serum helper T lymphocyte factor level and pulmonary function in patients with COPD

目的 探讨血清辅助性T淋巴细胞1(Th1)/辅助性T淋巴细胞2(Th2)因子水平变化与慢性阻塞性肺疾病(COPD)患者肺功能的关系。方法 选取COPD急性期(AECOPD)患者52例为AECOPD组、COPD稳定期(SCOPD)患者43例为SCOPD组、健康体检者30例作为对照组。收集三组临床资料;取AECOPD组患者急性加重次日,SCOPD组及对照组清晨空腹静脉血,分离血清,用ELISA法检测血清Th1细胞因子(IL-2、INF-γ、TNF-α)、Th2细胞因子(IL-4、IL-6、IL-10);测定肺功能,记录受试者第1秒用力呼气容积占预测值百分比(FEV_(1)/pred)及第1秒用力呼气容积/用力肺活量(FEV_(1)/FVC);各细胞因子与肺功能指标的相关性分析采用Pearson相关法。结果 与对照组比较,AECOPD组、SCOPD组血清IL-2水平低(P均<0.05),血清IL-4、IL-6、IL-10、IFN-γ、TNF-α水平高(P均<0.05);与SCOPD组比较,AECOPD组血清IL-2水平低(P均<0.05),血清IL-4、IL-6、IL-10、IFN-γ、TNF-α水平高(P均<0.05)。与对照组比较,AECOPD组、SCOPD组FEV_(1)/FVC、FEV_(1)/Pred低(P均<0.05);与SCOPD组比较,AECOPD组FEV_(1)/FVC、FEV_(1)/Pred低(P均<0.05)。AECOPD组血清IL-2水平与FEV_(1)/FVC、FEV_(1)/Pred呈正相关(P均<0.05),血清IL-4、IL-6、IL-10、TNF-α、IFN-γ水平与FEV_(1)/FVC、FEV_(1)/Pred呈负相关(P均<0.05);SCOPD组血清IL-2水平与FEV_(1)/FVC、FEV_(1)/Pred呈正相关(P均<0.05),血清IL-4、IL-6、IL-10、TNF-α水平与FEV_(1)/FVC、FEV_(1)/Pred呈负相关(P均<0.05),血清IFN-γ水平与FEV_(1)/FVC、FEV_(1)/Pred无相关性(P均>0.05)。结论 COPD患者Th1/Th2因子失衡,细胞因子水平变化可反映患者肺功能状态。

Objective To investigate the relationships between serum T helper 1(Th1)/T helper 2(Th2) factor levels and pulmonary function in patients with chronic obstructive pulmonary disease(COPD).Methods Fifty-two patients with acute exacerbation of COPD(AECOPD) were selected as the AECOPD group,43 patients with stable COPD(SCOPD) were selected as the SCOPD group,and 30 healthy subjects were selected as the control group.Clinical data of three groups were collected.The fasting venous blood of patients in AECOPD group on the day after acute exacerbation,SCOPD group and control group in the morning was collected and the serum was separated,serum Th1 cytokines(IL-2,INF-γ,TNF-α),and Th2 cytokines(IL-4,IL-6,IL-10) were detected by ELISA.Pulmonary function was measured,the percentage of forced expiratory volume in the first second(FEV_(1)/pred) and the percentage of forced expiratory volume in the first second(FEV_(1)/FVC) were recorded.Pearson correlation method was used to analyze the correlations between cytokines and lung function indexes.Results Compared with the control group,the levels of serum IL-2 in AECOPD group and SCOPD group were lower(all P0.05).Conclusion Th1/Th2 factors are unbalanced in COPD patients,and the changes of cytokine levels can reflect the pulmonary function status of patients.