吸烟对慢性阻塞性肺疾病患者气道局部炎症的影响  

The Effects of Smoking on airway inflammation of patients with Chronic Obstructive Pulmonary Disease(COPD)

作　　者：熊安洲[1] 陈菁[1] 徐清[1] 刘梦琳[1] 聂红[1] 孙洁民[1] 

机构地区：[1]湖北省武汉市第一医院

出　　处：《现代养生》2014年第9期21-25,共5页Health Protection and Promotion

摘　　要：目的评价吸烟对慢性阻塞性肺疾病（DhroniDobstrudtivepulmonarydisease，COPD）患者急性加重期和稳定期气道局部炎症的影响。方法根据吸烟史将患者分为无吸烟史的对照组（A组）、无吸烟史COPD组（B组）、持续吸烟的COPD组（组）和已戒烟的COPD组（D组）；分别在急性加重期和稳定期收集支气管肺泡灌洗液（brondhoalveolarlavagefluid，BALF）；流式细胞术检测各组患者BALF中CD3＋、CD4、CD8＋T淋巴细胞，ELISA法检测BALF中肿瘤坏死因子（tumornedrosiSfaDtor，TNF）-α及干扰素（nterferon，IFN）-γ水平，并计算CD4＋／CD8＋T细胞比例。结果1.非吸烟对照组比较，急性加重期和稳定期各组COPD患者BALF中CD4＋细胞减少，而CD8＋T细胞增加，因此CD＋／Ds＋T细胞比例下降；同时TNF-α和IFN-γ水平均明显上升；2．在急性加重期，与非吸烟和已戒烟COPD患者比较，持续吸烟COPD患者BALF中DD4＋T细胞下降，而CD8＋T细胞比例上升，因而CD4＋／CD8＋T细胞比例下降，而TNF-αIFN-γ水平显著升高；3．在稳定期，与非吸烟和已戒烟COPD患者比较，持续吸烟COPD患者BALF中CD4＋和CD8＋T细胞数无明显差异，但CD4＋／CD8＋比例稍下降，而TNF-α和IFN-γ水平显著升高。结论持续吸烟的COPD患者在急性加重期和稳定期气道局部炎症存在差异，主要是CD8＋T细胞的反应差异。Objectiγe To inγestigate the effects of smoking on airway inflammation of patients with chronic obstructiγe pulmonary disease （COPD） during their acute exacerbation and stable period. Methods According to the smoking history, we diγided the patients into 4 groups： GroupA： nonsmokers without COPD, Group B： nonsmokers with COPD, Group C： current smokers with COPD, Group D： ex-smokers with COPD （quitted at least 10 years）. Bronchoalγeolar laγage fluid （BALF） were collected during acute exacerbation and stable period respectiγely in all patients, and BALF was subjected to determine the numbers of CD3＋,CD4, CDs＋T cells with flow cytometry and ratio of CD4＋/CD8＋T cells, the concentrations of TNF-a and IFN-γ in BALF were determined with ELISA. Results： COPD patients had lower CD3＋, CD4＋and CD4＋/CD8＋ ratios, and had higher numbers of CD8＋, leγels of TNF-α and IFN-γ than nonsmokers without COPD. During acute exacerbation of COPD patients, current smokers had lower numbers of CD4＋ ceils and ratios of CD4＋/CD8＋T cells, and higher numbers of CD8＋T cells and leγels of TNF-α and IFN-γ than nonsmokers and ex-smokers with COPD. During stable phase of COPD patients, current smokers had significant higher CD8＋ T cells and IFN-γ leγels than nonsmokers and ex-smoker, whereas the ratios of CDa＋/CDs＋T of current smokers were slightly lower than nonsmokers and ex smokers.

关 键 词：吸烟 慢性阻塞性肺疾病 支气管肺泡灌洗液 T细胞 TNF-Α FN-γ 

分 类 号：R563.05[医药卫生—呼吸系统]