慢性阻塞性肺疾病患者肺泡灌洗液和外周血中T淋巴细胞活化状态的比较  

Comparison of Activation State of Pulmonary and Circulating T Cells in COPD Patients

作　　者：辛磊 刘倩 王贤 侯嘉[4] XIN Lei;LIU Qian;WANG Xian;HOU Jia(Ningxia Medical University,Yinchuan 750004;Operation Room of Yinchuan GuoLong Hospital,Yinchuan 750004;Department of Anesthesiology in Yinchuan GuoLong Hospital,Yinchuan 750004;Department of Respiratory and Critical Care Medicine,the General Hospital of Ningxia Medical University,Yinchuan 750004)

机构地区：[1]宁夏医科大学,银川750004 [2]银川国龙医院手术室,银川750004 [3]银川国龙医院麻醉科,银川750004 [4]宁夏医科大学总医院呼吸与危重症医学科,银川750004

出　　处：《宁夏医科大学学报》2018年第6期626-630,共5页Journal of Ningxia Medical University

基　　金：宁夏医科大学优势学科群建设科研项目(2001210105)

摘　　要：目的比较慢性阻塞性肺疾病(COPD)患者T淋巴细胞在肺泡灌洗液(BAL)和外周血中的活化状态,并探讨其与COPD严重程度的关系。方法采用流式细胞技术检测稳定期COPD患者20例、肺功能正常的吸烟者18例、健康非吸烟者19例的BAL和外周血CD4^+、CD8^+T淋巴细胞的活化标记:HLA-DR、CD38、CD69、CD28、CD45RA的表达水平,分析T淋巴细胞活化水平与COPD疾病严重程度的关系。结果与健康非吸烟组和健康吸烟组相比,COPD患者外周血中CD8^+CD38^+T细胞和CD8^+HLA-DR^+T细胞比例均升高(P均<0.01)。与外周血比较,BAL的CD4^+CD69^+T细胞和CD8^+CD69^+T细胞的活化比例增高(P<0.05)。COPD患者BAL中CD8^+HLA-DR^+T和CD8^+CD38^+T细胞的比例高于对照组(P<0.05)。在外周血和BAL中,COPD患者CD8^+HLA-DR^+T细胞及CD8^+CD38^+T细胞比例与第1秒用力呼气容积占预计值百分比(FEV1%)均呈负相关关系(P<0.05)。结论 COPD患者的肺泡灌洗液和外周血中的T淋巴细胞具有不同的活化状态,并与COPD的严重程度有一定相关性。Objective To investigate different activation state of pulmonary and circulating T cells in COPD patients,and find the relationship between lymphocyte activation phenotype and disease severity. Methods Flow cytometry was used to detect the expression levels of activation markers （HLA-DR,CD38, CD69, CD28, CD45RA） on T lymphocyte subsets（CD4＋T and CD8＋T ）obtained by bronchoalveolar lavage （BAL）and in peripheral blood among 20 previous smokers with stable COPD, 18 current smokers with normal lung function and 19 healthy non-smokers. The relationship between the activation levels of T cells and the severity of the disease was analyzed. Results Compared with healthy non smoking group and healthy smoking group, the proportion of CD4＋CD38＋T cells and CD8＋HLA-DR＋T cells in peripheral blood of COPD patients increased （P〈0.01）. Compared with peripheral blood,the activation ratio of CD4＋CD69＋T cells and CD8＋CD69＋T cells in BAL increased （P〈0.05）. The proportion of CDS＋HLA-DR＊F and CDS＋CD38＋T cells in BAL of COPD patients was higher than that of control group （P〈0.05）. In peripheral blood and BAL,the proportion of CD8＋HLA-DR＋F and CD8＋CD38＋F cells in COPD patients was negatively correlated with the percentage of predicted forced expiratory volume in the first second （FEV 1%） （P〈0.05）. Conclusion T cells in bronchoalveolar lavage fluid and peripheral blood of COPD patients have different activation states, and are correlated with the severity of COPD.

关 键 词：慢性阻塞性肺疾病 外周血T淋巴细胞 怖泡灌洗液 

分 类 号：R563.9[医药卫生—呼吸系统]