老年慢性阻塞性肺疾病患者辅助性T细胞17/调节性T细胞水平与肺功能的相关性研究  

Correlation between T helper 17 cells/regulatory T cells and pulmonary function in elderly patients with chronic obstructive pulmonary disease

作　　者：戴克芬 余倩 王文婧 杨晓兰[1] 汪艳丽 邬亭亭[1] Dai Kefen;Yu Qian;Wang Wenjing;Yang Xiaolan;Wang Yanli;Wu Tingting(Department of Respiratory Medicine,Third People's Hospital of Chengdu City,Chengdu,Sichuan,610000,P.R.China)

机构地区：[1]成都市第三人民医院呼吸内科,四川成都610000

出　　处：《老年医学与保健》2020年第5期815-819,共5页Geriatrics & Health Care

基　　金：四川省卫生和计划生育委员会科研项目(17PJ381)。

摘　　要：目的分析老年慢性阻塞性肺疾病(COPD)患者辅助性T细胞17(Th17)/调节性T细胞(Treg细胞)水平与肺功能的相关性,为诊治COPD提供参考。方法选取2017年1月-2020年2月在成都市第三人民医院治疗的老年COPD患者110例设为观察组,其中61例稳定期患者作为稳定期组,49例急性加重期患者作为加重期组;另选同期健康体检者70例设为对照组。观察并比较3组受试者的外周血中Th17、Treg细胞分数和Th17/Treg值,及第1秒用力呼气容积占预计值百分比(FEV1%)、用力肺活量占预计值百分比(FVC%)和FEV1/FVC值肺功能指标变化;采用Spearman相关分析方法对老年COPD患者外周血中Th17/Treg水平与肺功能指标进行相关性分析。结果3组受试者的Th17细胞分数、Th17/Treg值和Treg细胞分数比较差异显著(P<0.05);加重期组Th17细胞分数、Th17/Treg值均高于对照组和稳定期组(0.05),Treg细胞分数低于对照组和稳定期组(P<0.05)。3组受试者的FEV1(%)、FEV1/FVC和FVC(%)差异显著(P<0.05),加重期组FEV1(%)、FEV1/FVC和FVC(%)均低于稳定期组和对照组(P<0.05);Spearman分析显示,老年COPD患者外周血Treg细胞分数与FVC、FEV1、FEV1/FVC均呈正相关(P<0.05),Th17细胞分数与FEV1、FEV1/FVC均呈负相关(P<0.05),Th17/Treg值与FVC、FEV1、FEV1/FVC均呈负相关(P<0.05);直线散点图显示Treg细胞分数与FVC、FEV1、FEV1/FVC存在直线相关性(2=0.219、0.237、0.184),Th17细胞分数与FEV1、FEV1/FVC存在直线相关性(R^2=0.218,0.174),Th17/Treg值与FVC、FEV1、FEV1/FVC存在直线相关性(R^2=0.151、0.175、0.168)。结论老年COPD患者Th17/Treg细胞出现失衡,Th17/Treg细胞失衡可能与患者肺功能损伤密切相关。Objective To analyze the correlation between the level of T helper 17(Th17)cells/regulatory T cells(Treg cells)and pulmonary function in elderly patients with chronic obstructive pulmonary disease(COPD)so as to provide reference for clinical diagnosis and treatment of the disease.Methods 110 elderly COPD patients treated in the third people’s hospital of Chengdu from January 2017 to February 2020 were selected as the observation group,including 61 patients with stable period as the stable group,and 49 patients with acute exacerbation as the exacerbation group.Meanwhile,70 healthy subjects were recruited as the control group.The levels of Th17,Treg cell fraction,Th17/Treg value in peripheral blood,and forced expiratory volume in 1 second as a percentage of the predicted value(FEV1%),forced vital capacity as a percentage of the predicted value(FVC%)and FEV1/FVC were compared among the three groups.Spearman correlation analysis method was used to analyze the correlation between Th17/Treg level in peripheral blood and lung function indexes in elderly COPD patients.Results There were significant differences in Th17 cell fraction,Th17/Treg value and Treg cell fraction among the three groups(P<0.05).The Th17 cell fraction and Th17/Treg value in the exacerbation group were significantly higher than those in the control group and the stable group P<0.05),while the Treg cell fraction was significantly lower than that in the control group and the stable group(P<0.05).Spearman analysis showed that Treg cell fraction of elderly COPD patients was positively correlated with FVC,FEV1 and FEV1/FVC(P<0.05),Th17 cell fraction was negatively correlated with FEV1 and FEV1/FVC(P<0.05),and Th17/Treg was negatively correlated with FVC,FEV1,FEV1/FVC(P<0.05).The linear scatter plot showed that there was a linear correlation between Treg cell fraction and FVC,FEV1,FEV1/FVC(R^2=0.219,0.237,0.184),and a linear correlation between Th17 cell fraction and FEV1,FEV1/FVC(R^2=0.218,0.17).Conclusion Th17/Treg cell imbalance is found in elderly pa

关 键 词：老年 慢性阻塞性肺疾病 辅助性T细胞17 调节性T细胞 肺功能 

分 类 号：R563.9[医药卫生—呼吸系统]