慢性阻塞性肺疾病和阻塞性睡眠呼吸暂停低通气综合征重叠综合征患者免疫功能的变化  

Changes of immune function in the overlap syndrome patients with chronic obstructive pulmonary disease and obstructive sleep apnea hypopnea syndrome

作　　者：朱建勇[1] 王永兰[1] 曾玉琴[2] 李俊敏[1] 邝军[1] 何敏[1] 

机构地区：[1]湖北医药学院附属人民医院呼吸内科,十堰442000 [2]湖北医药学院附属太和医院内分泌科,十堰442000

出　　处：《中华肺部疾病杂志（电子版）》2016年第5期512-515,共4页Chinese Journal of Lung Diseases(Electronic Edition)

基　　金：湖北省教育厅科学技术研究项目(B2014043)

摘　　要：目的探讨慢性阻塞性肺疾病(COPD)合并阻塞性睡眠呼吸暂停低通气综合征(OSAHS)[重叠综合征(OS)]患者免疫功能特点。方法选取78例COPD稳定期(COPD组)、70例OSAHS(OSAHS组)、58例OS(OS组)患者和32名健康者(健康组)为对象,采用流式细胞仪、免疫散射比浊法分别对其细胞免疫(CD4^+、CD8^+、CD4^+/CD8^+)和体液免疫(Ig A、Ig G、Ig M)水平进行检测;其中30例OS患者在进行双水平气道正压(BiPAP)通气治疗3个月后对上述指标进行复测。结果与健康组相比,COPD、OSAHS和OS患者CD4^+、CD4^+/CD8^+、Ig A、Ig G、Ig M的水平下降(t=2.851~12.897,P<0.05);与COPD、OSAHS组相比,OS组患者上述免疫指标更低(t=2.756~3.075,P<0.05);30例OS患者在Bi PAP治疗后上述免疫指标上升,差异具有统计学意义(t=2.367~3.758,P<0.05)。结论 COPD合并OSAHS的OS患者免疫功能更为低下,在临床上应引起足够重视,Bi PAP通气治疗有助于改善其免疫功能。Objective To explore the characteristics of immune function in the overlap syndrome patients（OS） with chronic obstructive pulmonary disease （COPD）and obstructive sleep apnea hypopnea syndrome （OSAHS）. Methods All 78 patients with stable COPD （COPD group）, 70 patients with OSAHS （OSAHS group）, 58 patients with OS （OS group）, and 32 healthy adults （healthy group） were collected, the levels of cellular（ CD4＋, CD8＋, CD4＋/CD8＋） and humoral immunity（ IgA, IgM, IgG）were detected by flow cytometry and immune scatter turbidity method. The 30 patients from the OS group were treated with bi-level positive airway pressure （ BiPAP ） ventilation for 3 months later, this indexes were detected again. Results Compared to the healthy group, The levels of CD4＋, CD4＋/CD8＋, IgM, IgA and IgG in the COPD, OSAHS and OS groups were significantly lower（t= 2.851-12.897, P〈0.05） ; Compared to COPD and OSAHS groups, The levels of these indexes in the OS groups were also significantly lower （t = 2.756-3.075, P〈0.05） ; The levels of these indexes were significantly higher in the 30 OS patients after treated with BiPAP ventilation for 3 months later, the difference was statistically significant （ t = 2.367-3.758, P〈0.05）. Conclusion The immune function in OS patients may be lower than that of COPD and OSAHS patients, great attention should be paid for those patients in clinic, the BiPAP ventilation therapy can improve that.

关 键 词：肺疾病 慢性阻塞性 低通气综合征 睡眠呼吸暂停 阻塞性 重叠综合征 免疫功能 

分 类 号：R563[医药卫生—呼吸系统]