Th1/Th2失衡及细胞因子与慢性阻塞性肺疾病急性加重的相关性研究  

Correlation of Th1/Th2 imbalance and cytokines with acute exacerbation of chronic obstructive pulmonary disease

作　　者：刘海燕 裴复阳[1] 王涛[1] Liu Haiyan;Pei Fuyang;Wang Tao(Department of Respiratory Medicine,Zhongshan Hospital,Dalian University,Dalian 116001,China)

机构地区：[1]大连大学附属中山医院呼吸科,大连116001

出　　处：《国际呼吸杂志》2022年第16期1242-1248,共7页International Journal of Respiration

摘　　要：目的分析Th1/Th2失衡及细胞因子在慢性阻塞性肺疾病急性加重(AECOPD)的变化,探讨其在AECOPD中的作用。方法本研究为病例对照研究。采用非随机抽样法,选取2021年3月至2021年12月大连大学附属中山医院住院的AECOPD患者150例为研究组,同时选取稳定期COPD(SCOPD)患者40例为SCOPD组及健康组22例。根据《慢性阻塞性肺疾病诊治指南(2021年修订版)》中AECOPD临床分级标准将AECOPD组分为AECOPDⅠ级组(n=48)、Ⅱ级组(n=55)、Ⅲ级组(n=47)。以流式细胞技术检测干扰素γ(IFN-γ)、白细胞介素4(IL-4)、IL-17、IL-10,以IFN-γ/IL-4的比值作为Th1/Th2。进行单因素方差分析。分析以上指标在AECOPD的变化,及其与炎症指标、肺功能参数、AECOPD临床分级的相关性。结果(1)AECOPD组第1秒用力呼气容积占预计值百分比(FEV1%pred)、FEV1/用力肺活量(FVC)低于SCOPD组和健康组,中性粒细胞与淋巴细胞比值(NLR)、C反应蛋白(CRP)高于SCOPD组和健康组(P值均<0.05)。(2)AECOPD组Th1/Th2低于SCOPD组和健康组(P值均<0.05),IFN-γ、IL-4、IL-10、IL-17高于SCOPD组和健康组(P值均<0.05)。(3)AECOPD各亚组NLR、CRP由低到高为AECOPDⅠ级<AECOPDⅡ级<AECOPDⅢ级(P值均<0.05);FEV1%pred、FEV1/FVC由高到低为AECOPDⅠ级>AECOPDⅡ级>AECOPDⅢ级(P值均<0.05)。(4)AECOPD各亚组Th1/Th2、IL-10由高到低为AECOPDⅠ级>AECOPDⅡ级>AECOPDⅢ级(P值均<0.05);IL-17由低到高为AECOPDⅠ级<AECOPDⅡ级<AECOPDⅢ级(P值均<0.05)。(5)AECOPD组Th1/Th2、IL-10、IL-17与NLR、CRP、FEV1%pred、FEV1/FVC、AECOPD临床分级具有相关性。结论Th1/Th2与细胞因子有助于判断COPD是否发生急性加重,并可评估AECOPD严重程度。Objective To analyze the changes of Th1/Th2 imbalance and cytokines in acute exacerbation of chronic obstructive pulmonary disease(AECOPD),and to explore its role in AECOPD.Methods This was a case-control study.A total of 150 AECOPD patients in Zhongshan Hospital affiliated to Dalian University from March 2021 to December 2021 were selected as the study group by non-random sampling method.Meanwhile,40 patients with stable COPD(SCOPD)were selected as SCOPD group,and 22 cases in healthy group were selected.The AECOPD group was divided into AECOPD groupⅠ(n=48),groupⅡ(n=55),and groupⅢ(n=47)according to the clinical grading standards of AECOPD in guidelines for the Diagnosis and Treatment of Chronic Obstructive Pulmonary Disease(revised edition 2021).IFN-γ,interleukin-4(IL-4),IL-17,and IL-10 were detected by flow cytometry,and the ratio of IFN-γ/IL-4 was used as Th1/Th2.One-way ANOVA was performed.The changes of the above indicators in AECOPD and their correlation with inflammatory indicators,lung function parameters,and clinical grade of AECOPD were analyzed.Results(1)In the AECOPD group,forced expiratory volume in the first second in percent predicted values(FEV1%pred)and FEV1/forced vital capacity(FVC)were lower than those in SCOPD group and healthy group,neutrophil to lymphocyte ratio(NLR)and C-reactive protein(CRP)were higher than those in SCOPD group and healthy group(all P<0.05).(2)Th1/Th2 in AECOPD group was lower than that in SCOPD group and healthy group(all P<0.05),while IFN-γ,IL-4,IL-10 and IL-17 were higher than those in SCOPD group and healthy group(all P<0.05).(3)The order of NLR and CRP in AECOPD subgroups from low to high was AECOPDⅠ<AECOPDⅡ<AECOPDⅢ(all P<0.05).The order of FEV1%pred and FEV1/FVC from high to low was AECOPDⅠ>AECOPDⅡ>AECOPDⅢ(all P<0.05).(4)The order of Th1/Th2 and IL-10 in AECOPD subgroups from high to low was AECOPDⅠ>AECOPDⅡ>AECOPDⅢ(all P<0.05).The order of IL-17 from low to high was AECOPDⅠ<AECOPDⅡ<AECOPDⅢ(all P<0.05).(5)In AECOPD group,Th1/Th2,IL-10,

关 键 词：肺疾病 慢性阻塞性 急性加重期 TH1/TH2 细胞因子 相关性分析 

分 类 号：R563.9[医药卫生—呼吸系统]