慢性阻塞性肺疾患者病程中免疫功能状况的临床观察  

作　　者：余雪姣 陈秀花[1] 单旦萍 

机构地区：[1]浙江省衢州市人民医院检验科,324000 [2]浙江省嘉兴市第二医院检验科,314000

出　　处：《浙江临床医学》2018年第4期737-738,共2页Zhejiang Clinical Medical Journal

摘　　要：目的探讨老年人慢性阻塞性肺疾病（COPD）患者外周血淋巴细胞亚群及免疫球蛋白在病程中的变化规律。方法选择2012年3月至2017年5月呼吸内科门诊和病房收治的200例COPD急性加重期患者，174例病情稳定期患者，同时选择160例健康老年体检者作为对照。均进行外周血淋巴细胞亚群及免疫球蛋白IgA、IgG、IgM的测定，并计算出CD4^＋／CD8^＋比值。统计分析COPD患者与健康者，COPD急性加重期与稳定期外周血淋巴细胞亚群及免疫球蛋白的差异。结果COPD患者外周血CD3^＋、CD4^＋、NK细胞水平和CD4^＋／CD8^＋比值均低于健康对照组，CD8^＋、IgA、IgG水平高于健康对照组，各项指标比较差异均有统计学意义（p均〈0．05）；COPD急性加重期患者外周血CD3^＋、CD4^＋、NK细胞比COPD稳定期患者进一步降低，而IgG高于稳定期患者，差异均有统计学意义（P均〈0．05）。结论老年COPD患者存在一定的免疫功能异常，且抑制程度与疾病轻重呈正相关。外周血淋巴细胞亚群及免疫球蛋白含量的变化对COPD患者病情监测及预后病情判断具有重要意义。在疾病治疗的时应同时采用有效方法提高机体细胞免疫和体液免疫水平，对维持机体免疫和提高疗效具有显著意义。Objective To investigate the changes of the level of lymphocyte subsets and immunoglobulins in the elder patients with chronic obstructive pulmonary disease. Methods The patients were divided intol00 acute critically group and 87 stable phase patients according to the severity of disease, 80 healthy people as control group, those were admitted in this hospital from Mar 2012 to May 2017.The level of lymphocyte subsets and IgA, IgG, IgM were measured for all patients, and the ratio of CD4^＋/CD8^＋ was calculated. COPD patients and healthy people, stable phase patients and acute group patients, respectively. Results The levels of CD3^＋, CD4^＋, NK cell and the ratio of CD4^＋/CD8^＋ were lower in COPD patients than in the control group, CD8^＋, IgA, IgG were higher than the control group. These parameters were significantly different, all P〈0.05.The levels of CD3^＋, CD4^＋ and NK cell were lower in acute critically group than in stable phase group, IgG was higher than the stable phase group. These parameters were significandy different, P〈0.05 for all. Conclusion The levels of lymphocyte subsets and immunoglobulins are significandy abnormal in COPD patients, and the level of suppression is posirively correlated to severity of the illness. The changes of lymphocyte subsets and immunoglobulins have significance on the monitoring and prognosis in COPD patients. We should improve the immunity of patients in the process of therapy. It has important significance to support immune function and increase curative effect.

关 键 词：慢性阻塞性肺疾病 淋巴细胞亚群 免疫球蛋白 老年人 

分 类 号：R392.11[医药卫生—免疫学]