AECOPD合并肺炎患者外周血CD16^(+)/56^(+)NK细胞及IL-12p70、IL-10、IL-4、IFN-γ表达水平及意义分析  

Expression levels and significance of peripheral blood CD16^(+)/56^(+)NK cells and IL-12p70,IL-10,IL-4 and IFN-γin patients with AECOPD complicated with pneumonia

作　　者：于书娴 张威 刘汶睿 周建刚 高丽娜 李宗广 俞军[2] YU Shuxian;ZHANG Wei;LIU Wenrui;ZHOU Jiangang;GAO Lina;LI Zongguang;YU Jun(Department of Respiratory Medicine,The Fourth Affiliated Hospital of Nanjing Medical University,Nanjing,Jiangsu 210031,China;Molecular Laboratory,Jiangsu Cancer Hospital,Nanjing,Jiangsu 210009,China)

机构地区：[1]南京医科大学第四附属医院呼吸内科,江苏南京210031 [2]江苏省肿瘤医院分子实验室,江苏南京210009

出　　处：《临床肺科杂志》2023年第7期1024-1029,共6页Journal of Clinical Pulmonary Medicine

基　　金：江苏省卫健委重点项目(No.ZD2021012)。

摘　　要：目的探究慢性阻塞性肺疾病急性加重期(AECOPD)合并肺炎患者外周血CD16^(+)/56^(+)自然杀伤(NK)细胞、白介素-12p70(IL-12p70)、白介素-10(IL-10)、白介素-4(IL-4)、干扰素-γ(IFN-γ)表达及临床意义。方法选取274例AECOPD患者,根据是否合并肺炎分为单纯AECOPD组89例、AECOPD合并肺炎组185例(根据肺炎严重程度分为重症组85例、非重症组100例),检测患者入院时外周血CD16^(+)/56^(+)NK细胞及IL-12p70、IL-10、IL-4、IFN-γ表达水平。结果AECOPD合并肺炎组血清IL-12p70、IL-10、IL-4、IFN-γ水平均高于单纯AECOPD组,且重症组均高于非重症组(P<0.05),但不同组外周血CD16^(+)/56^(+)NK细胞比较均差异无统计学意义(P>0.05);Spearman秩相关显示,AECOPD患者血清IL-12p70与IL-10、IL-4、IFN-γ表达呈正相关(P<0.05),但外周血CD16^(+)/56^(+)NK细胞与血清IL-12p70、IL-10、IL-4、IFN-γ表达均无显著相关性(P>0.05);血清IL-12p70、IL-10、IL-4、IFN-γ及四者联合预测AECOPD合并肺炎的AUC分别为0.677、0.778、0.618、0.717、0.789,预测AECOPD合并重症肺炎的AUC分别为0.600、0.682、0.611、0.598、0.687。结论AECOPD合并肺炎患者血清IL-12p70、IL-10、IL-4、IFN-γ表达均明显升高,且在重症肺炎中表达更高,其中以IL-10、IFN-γ对AECOPD合并肺炎预测价值较高,而联合检测预测价值更高。Objective To investigate the expressions and clinical significance of peripheral blood CD16^(+)/56^(+)natural killer(NK)cells,interleukin-12p70(IL-12p70),interleukin-10(IL-10),interleukin-4(IL-4),and interferon-γ(IFN-γ)in patients with acute exacerbation of chronic obstructive pulmonary disease(AECOPD)complicated with pneumonia.Methods A total of 274 patients with AECOPD were selected and divided into 89 cases in the simple AECOPD group and 185 cases in the AECOPD with pneumonia group(85 cases in the severe group and 100 cases in non-severe group by means of pneumonia severity)according to whether the patients were complicated with pneumonia.The expression levels of peripheral blood CD16^(+)/56^(+)NK cells and IL-12p70,IL-10,IL-4,and IFN-γin the peripheral blood of patients were detected upon admission.Results Serum levels of IL-12p70,IL-10,IL-4,and IFN-γin the AECOPD with pneumonia group were higher than those in the simple AECOPD group,and those in the severe group were higher than the non-severe group(P<0.05),but there was no statistical significance in the level of peripheral blood CD16^(+)/56^(+)NK cells between different groups(P>0.05).Spearman rank correlation showed that the expression of serum IL-12p70,IL-10,IL-4,and IFN-γin patients with AECOPD was positively correlated with each other(P<0.05).However,there was no significant correlation between peripheral blood CD16^(+)/56^(+)NK cells and the expression of serum IL-12p70,IL-10,IL-4,and IFN-γ(P>0.05).The AUCs of serum IL-12p70,IL-10,IL-4,IFN-γ,and the combination of the four in predicting AECOPD with pneumonia were 0.677,0.778,0.618,0.717,and 0.789,respectively,and the AUC of predicting AECOPD with severe pneumonia were 0.600,0.682,0.611,0.598,and 0.687.Conclusion The expression of serum IL-12p70,IL-10,IL-4,and IFN-γin patients with AECOPD complicated with pneumonia is significantly increased,and the expression is higher in severe pneumonia.IL-10 and IFN-γhave higher predictive values on AECOPD complicated with pneumonia,and the predictive valu

关 键 词：慢性阻塞性肺疾病急性加重期 CD16^(+)/56^(+)自然杀伤细胞 白介素-12p70 白介素-10 白介素-4 干扰素-Γ 

分 类 号：R563.9[医药卫生—呼吸系统] R563.1[医药卫生—内科学]