AECOPD患者T淋巴细胞与肺功能及炎症指标的相关性研究

Relationship between T lymphocyte and lung function,inflammatory indicators in patients with AECOPD

目的 探讨慢性阻塞性肺疾病急性加重期(acute exacerbation of chronic obstructive pulmonary disease,AECOPD)患者T淋巴细胞亚群与肺功能、超敏C反应蛋白(C-reactive protein,CRP)、一年急性加重次数的关系。方法 对66例AECOPD老年患者和63例健康老年人的资料进行分析,比较超敏CRP、总T淋巴细胞数目(CD3)、辅助性T淋巴细胞(CD4)、杀伤性T淋巴细胞(CD8)及辅助与杀伤细胞比值(CD4/CD8)的差异。将AECOPD患者按慢性阻塞性肺疾病全球倡议(Global Initiative for Chronic Obstructive Lung Disease,GOLD)分级分为I—Ⅱ级组和Ⅲ—Ⅳ级组,比较不同组CD3、CD4、CD8、CD4/CD8、超敏CRP的差异。分析CD3、CD4、CD8、CD4/CD8与FEV1%pred、FEV1/FVC、超敏CRP、一年急性加重次数的相关性。结果 AECOPD组和健康对照组的体重指数、FEV1%pred、CD3、CD4、CD8、CD4/CD8、超敏CRP差异均有显著性(P <0.05);Ⅰ—Ⅱ级组、Ⅲ—Ⅳ级组的CD3、CD4、CD4/CD8、超敏CRP水平不同(P <0.05);CD3、CD4、CD4/CD8与FEV1%pred、FEV1/FVC呈正相关,与超敏CRP、急性加重次数呈负相关(P <0.05)。结论 AECOPD患者外周血CD3、CD4、CD4/CD8与肺功能、急性加重次数存在相关性,T淋巴细胞亚群或可作为判断COPD患者预后的指标。

Objective To investigate the relationship among T lymphocyte subsets and lung function,hypersensitive C-reactive protein(CRP),and the number of acute exacerbations at one year in patients with acute exacerbation of chronic obstructive pulmonary disease(AECOPD).Methods The data of 66 elderly patients with AECOPD and 63 healthy elderly people were analyzed and compared.The differences in hypersensitivity CRP,total T lymphocyte count(CD3),helper T lymphocytes(CD4),killer T lymphocytes(CD8),and helper-to-killer cell ratio(CD4/CD8)were compared.AECOPD patients were divided into two groups(grade I-II group and grade III-IV group)according to Global Initiative for Chronic Obstructive Lung Disease(GOLD).The differences of CD3,CD4,CD8,CD4/CD8 and hypersensitivity CRP in different groups were compared.The correlation between CD3,CD4,CD8,CD4/CD8 and FEV1%pred,FEV1/FVC,hypersensitivity CRP,and the number of acute exacerbations at one year were analyzed.Results There were significant differences in body mass index,FEV1%pred,CD3,CD4,CD8,CD4/CD8 and hypersensitivity CRP between AECOPD group and healthy control group(P<0.05).The levels of CD3,CD4,CD4/CD8 and hypersensitivity CRP in the lung function grade I-II group and the III-IV group were different(P<0.05).CD3,CD4,CD4/CD8 were positively correlated with FEV1%pred and FEV1/FVC,and negatively correlated with hypersensitive CRP(P<0.05).Conclusion There is a significant correlation among peripheral blood CD3,CD4,CD4/CD8 and lung function and the number of acute exacerbations in patients with AECOPD,and T lymphocyte subsets can be used as indicators to judge the prognosis of COPD patients.