下呼吸道细菌定植对稳定期COPD患者炎性因子及免疫细胞水平的影响  

Effects of Lower Airway Bacterial Colonization to the Level of Inflammatory Factors and Immune Cells in Patients with Stable COPD

作　　者：石明[1] 杨中卫[1] 李威[1] 唐友勇[1] 王正艳[1] 

机构地区：[1]湖北医药学院附属东风医院呼吸内科,湖北十堰442008

出　　处：《医学综述》2016年第8期1585-1587,共3页Medical Recapitulate

摘　　要：目的研究下呼吸道细菌定植对稳定期慢性阻塞性肺疾病(COPD)患者炎性因子及免疫细胞水平的影响。方法选择2011年5月至2014年5月在湖北医药学院附属东风医院接受治疗的60例稳定期COPD患者为病例组,另外选取同期健康体检者60例作为健康组,比较两组研究对象的一般资料和免疫细胞水平。以细菌定植情况为依据,将病例组细分为无定植组(30例)和定植组(30例),比较两组患者的炎性细胞因子及免疫细胞的水平。结果病例组第一秒用力呼气量(FEV1)、FEV1/用力肺活量(FVC)低于健康组[(50±12)%比(79±14)%,(62±25)%比(85±13)%],吸烟量多于健康组[(34±7)包/年比(15±3)包/年],差异有统计学意义(P<0.05)。定植组痰白细胞介素6(IL-6)、痰IL-8、血IL-8、肿瘤坏死因子α(TNF-α)和血高敏C反应蛋白(hs-CRP)均高于无定植组[(193±80)ng/L比(133±60)ng/L,(433±165)ng/L比(226±96)ng/L,(58±16)ng/L比(32±14)ng/L,(173±61)μg/L比(111±39)μg/L,(11.1±3.2)mg/L比(5.4±2.1)mg/L],差异有统计学意义(P<0.05)。定植组巨噬细胞、辅助T细胞低于健康组和无定植组,抑制T细胞、中性粒细胞高于健康组和无定植组,差异均有统计学意义(P<0.05)。结论下呼吸道细菌定植可导致稳定期COPD患者炎性因子水平升高,且对患者的免疫功能具有重要的影响,加快患者病情恶化。Objective To study the effects of lower airway bacterial colonization to the level of inflammatory factors and immune cells of patients with stable stage of chronic obstructive pulmonary disease（ COPD）. Methods Sixty patients with stable stage of COPD in Dongfeng Affiliated Hospital of Hubei University of Medicine from May 2011 to May 2014 were included as case group and sixty healthy volunteers receiving health examination during the same period were included as healthy group. The general information and the level of immune cells of the two groups were compared. With the bacterial colonization as reference,the patients were divided into non-colonization group and colonization group,and the levels of inflammatory factors were compared between the two groups. Results Forced expiratory volume in 1 second（ FEV1）,FEV1/ forced vital capacity（ FVC） of the case group were lower than the healthy group [（ 50 ± 12） % vs（ 79 ± 14） %,（ 62 ± 25） % vs（ 85 ± 13） % ],smoking was higher than the healthy group [（ 34 ± 7）packet / year vs（ 15 ± 3） packet / year ],the differences were statistically significant（ P〈 0. 05）. Sputum IL-6,sputum IL-8,serum IL-8,tumor necrosis factor-α（ TNF-α） and high sensitivity C-reactive protein（ hs-CRP） blood of the colonization group were higher than the non-colonization group[（ 193 ± 80） ng/L vs（ 133 ± 60） ng/L,（ 433 ± 165） ng/L vs（ 226 ± 96） ng/L,（ 58 ± 16） ng/L vs（ 32 ± 14） ng/L,（ 173 ±61） μg / L vs（ 111 ± 39） μg / L,（ 11. 1 ± 3. 2） mg / L vs（ 5. 4 ± 2. 1） mg / L],the differences were statistically significant（ P〈 0. 05）. The macrophages,helper T cells of the colonization group were lower than the healthy group and non-colonization group,while inhibition of T cells,neutrophils were higher than the healthy group and non-colonization group,the differences were statistically significant（ P〈 0. 05）. Conclusion Lower airway bacterial colonization can rise the level of inflammatory f

关 键 词：慢性阻塞性肺疾病 下呼吸道 细菌定植 免疫情况 

分 类 号：R563[医药卫生—呼吸系统]