动态测定外周血Tc1/Tc2比值对评估老年慢性阻塞性肺病复发的价值研究  

The value of dynamic measurement of peripheral blood Tc1/Tc2 ratio in evaluating the recurrence of chronic obstructive pulmonary disease in the elderly

作　　者：刘明 王亚婷[2] 赵云峰[1] Liu Ming;Wang Yating;Zhao Yunfeng(Department of Respiratory Disease;Department of Clinical Lab,Punan Hospital,Pudong New District,Shanghai,200125,P.R.China;不详)

机构地区：[1]上海市浦东新区浦南医院呼吸科,上海200125 [2]上海市浦东新区浦南医院检验科,上海200125

出　　处：《老年医学与保健》2020年第5期830-833,842,共5页Geriatrics & Health Care

基　　金：上海市卫生和计划生育委员会课题(201740312);上海市浦东新区卫生系统领先人才培养计划(PWRl2017-01);上海市浦东新区卫生系统重点专科培养计划(PWZzk2017-18)。

摘　　要：目的检测不同吸烟状态的C和D级慢性阻塞性肺疾病(COPD)患者外周血CD8^+T淋巴细胞中TC1百分比和TC2百分比,探讨动态测定外周血TC1/TC2比值对评估老年COPD患者1年内复发的价值。方法选取2018年7月-2019年8月浦南医院呼吸科住院的C级和D级AECOPD老年患者90例,根据吸烟状态不同分为3组:吸烟组(n=30)、戒烟组(n=30)h和不吸烟组(n=30)。在入院时、出院时、6个月及12个月,采用流式细胞仪测定患者外周血CD8^+T淋巴细胞中IFN-和IL-4水平,以及血常规、hs-CRP、血清IL-6和IL-8浓度,记录患者肺功能(FEV1%)和CAT问卷评分等,并记录12个月内患者急性加重次数,计算不同时间点外周血TC1/TC2比值与其他指标的关系,分析其相关性。结果吸烟组COPD患者1年内急性加重次数明显高于戒烟组和不吸烟组,3组患者1年内的病死率分别为:16.67%、10.00%、3.30%,吸烟组病死率高于戒烟组和不吸烟组。入组时,3组外周血CD8^+T淋巴细胞中TC1百分比、TC2百分比、TC1/TC2比值、血hs-CRP、IL-6、IL-8浓度差异均有统计学意义(P<0.05),而WBC、FEV1%、CAT评分差异均无统计学意义(P>0.05)。随访1年后,3组患者外周血TC1百分率、TC2百分率、TC1/TC2比值、IL-6、IL-8有统计学差异(P<0.05),其他指标均无统计学差异。3组入院时,外周血TC1百分比、TC2百分比、TC1/TC2比值、IL-6、IL-8浓度、血WBC、血hs-CRP、CAT评分均高于出院时和随访1年后,而FEV1%低于出院时(P<0.05);吸烟组入院时TC1百分比、TC1/TC2比值高于戒烟组和不吸烟组,而TC2百分比低于戒烟组和不吸烟组(P<0.05);3组外周血TC1/TC2比值与IL-6、IL-8呈正相关(P<0.05),而与FEV1%呈负相关(P<0.05)。结论COPD患者外周血中TC1/TC2比值可能与慢性阻塞性肺疾病急性加重有关。Objective To detect the percentage of TC1 and TC2 in peripheral blood CD8^+T lymphocytes in patients with chronic obstructive pulmonary disease(COPD)of grade C and D in different smoking states,and to explore the value of dynamic measurement of TC1/TC2 ratio in peripheral blood in evaluating the recurrence of COPD patients within one year.Methods From July 2018 to August 2019,90 elderly patients with grade C and D AECOPD who were hospitalized in the respiratory department of Punan hospital were selected and divided into 3 groups according to their smoking status:smoking group(group A,n=30),smoking cessation group(group B,n=30)and non-smoking group(group C,n=30).At admission,discharge,6 months and 12 months later,the levels of IFN-and IL-4 in peripheral blood CD8^+T lymphocytes,blood routine test,serum hs-CRP,IL-6 and IL-8 concentrations were measured by flow cytometry,as well as their pulmonary function(FEV1%)and CAT questionnaire score were recorded.The frequency of acute exacerbations of COPD within 12 months was recorded.The relationship between TC1/TC2 ratio and other indexes at different time points was calculated,and the correlation was analyzed.Results The frequency of acute exacerbations within 1 year in group A was significantly higher than that in group B and C,and the mortality of patients within 1 year in 3 groups was 16.67%,10.00%and 3.30%,respectively.The mortality of group A was higher than that of group B and C.There were statistically significant differences in TC1 percentage,TC2 percentage,TC1/TC2 ratio in peripheral blood CD8^+T lymphocytes and hs-CRP,IL-6 and IL-8 concentrations among the 3 groups(P<0.05),but there were no statistically significant differences in blood WBC,FEV1%and CAT scores(P<0.05).After 1 year of follow-up,there were significant differences in the percentage of TC1,TC2,TC1/TC2,IL-6 and IL-8 in peripheral blood among the 3 groups(P<0.05),but there were no statistical difference in other indicators.The percentages of TC1 and TC2,TC1/TC2,IL-6,IL-8,WBC,hs-CRP and CAT scores of

关 键 词：老年 慢性阻塞性肺疾病 TC1百分比 TC2百分比 TC1/TC2比值 

分 类 号：R563.9[医药卫生—呼吸系统]