动态监测诱导痰Tc1/Tc2比值在COPD患者中的临床价值  

Clinical value of dynamic monitoring of induced sputum Tc1/Tc2 ratio in COPD patients

作　　者：邹凡 赵云峰[2] 刘明 ZOU Fan;ZHAO Yun-feng;LIU Ming(Changzheng Community Health Service Center of Putuo District,Shanghai200333,China;Department of Respiratory Medicine,Punan Hospital of Pudong New Area,Shanghai200125,China)

机构地区：[1]上海市普陀区长征镇社区卫生服务中心,上海200333 [2]上海市浦东新区浦南医院呼吸科,上海200125

出　　处：《临床肺科杂志》2021年第3期340-344,共5页Journal of Clinical Pulmonary Medicine

基　　金：上海市卫生和计划生育委员会面上课题(No.201740312);上海市浦东新区卫生系统领先人才培养计划(No.PWRl2017-01);上海市浦东新区卫生系统重点专科培养计划(No.PWZzk2017-18)。

摘　　要：目的探讨动态监测诱导痰Tc1/Tc2比值在COPD患者中的临床价值。方法选取90例研究对象,分为不吸烟组为A组、戒烟组为B组、吸烟组为C组,每组30人,D组10例正常对照。入组后动态监测入院时、出院时、出院6月及12月诱导痰中相关指标并进行统计学分析。结果A、B、C三组在各时间点CD8^(+)T细胞%、Tc1/Tc2比值两两比较,差异均有统计学意义(P<0.05);A、B、C各组入院时诱导痰CD8^(+)T细胞%、Tc1/Tc2比值均高于出院时和随访1年后,而FEV 1%均降低,差异有统计学意义(P<0.05)。各时间点FEV 1%值组间比较C组低于A组与B组,差异有统计学意义(P<0.05)。随访1年,各组研究对象急性加重次数两两比较均具有统计学差异(P<0.05)。诱导痰Tc1/Tc2比值与FEV 1%呈负相关性,与患者1年内急性加重次数呈正相关。结论COPD患者诱导痰中存在Tc1/Tc2免疫失衡,吸烟组CD8+T淋巴细胞所介导的炎症水平较高,Tc1/Tc2比值可能与COPD患者急性加重次数以及肺通气功能相关。Objective To explore the clinical value of dynamic monitoring of induced sputum Tc1/Tc2 ratio in COPD patients.Methods 90 subjects were selected and divided into the non-smoking group as the group A,the smoking cessation group as the group B,and the smoking group as the group C,30 cases in each group,and 10 normal controls were selected as the group D.After grouping,the relevant indicators of induced sputum were monitored dynamically at admission,discharge,6 months and 12 months after discharge,and statistical analysis was performed.Results There were significant differences in CD8^(+)T cell%and Tc1/Tc2 ratio among the groups A,B,and C at each time point(P<0.05).The levels of CD8+T cell%and Tc1/Tc2 ratio in induced sputum were higher at admission than at discharge and after 1 year of follow-up,while FEV 1%was lower(P<0.05).The FEV 1%value at each time point was lower in the group C than in the group A and the group B(P<0.05).After 1 year of follow-up,the number of acute exacerbations in each group was statistically different(P<0.05).The Tc1/Tc2 ratio in induced sputum was negatively correlated with FEV 1%,and positively correlated with the number of acute exacerbations within one year.Conclusion There is Tc1/Tc2 immune imbalance in induced sputum in COPD patients.The level of inflammation mediated by CD8^(+)T lymphocytes in the smoking group is higher.The ratio of Tc1/Tc2 may be related to the number of acute exacerbations and lung ventilation function in COPD patients.

关 键 词：慢性阻塞性肺疾病 诱导痰 CD8^(+)T淋巴细胞 TC1/TC2 

分 类 号：R563.9[医药卫生—呼吸系统]