慢性阻塞性肺疾病合并活动性肺结核患者血清细胞因子表达水平及其与疾病的相关性  

Expression levels of serum cytokines in patients with COPD combined with active tuberculosis and their correlation with the disease

作　　者：何庆军 姚文艳 校丹 李红兵 吴水淼 He Qingjun;Yao Wenyan;Xiao Dan;Li Hongbing;Wu Shuimiao(Department of Respiratory and Critical Care Medicine,The Fourth People's Hospital of Shaanxi Province,Shaanxi Xi'an 710043,China;Department of Respiratory and Critical Care Medicine,Weinan Central Hospital,Shaanxi Weinan 714000,China)

机构地区：[1]陕西省第四人民医院呼吸与危重症医学科,陕西西安710043 [2]渭南市中心医院呼吸与危重症医学科,陕西渭南714000

出　　处：《新发传染病电子杂志》2023年第4期15-19,共5页Electronic Journal of Emerging Infectious Diseases

基　　金：陕西省卫生健康科研基金项目(2021D014)。

摘　　要：目的分析慢性阻塞性肺疾病(COPD)合并活动性肺结核患者第1秒用力呼气容积(FEV1)水平与血清细胞因子水平间的相关性,为临床干预提供依据。方法将2019年1月至2022年4月于陕西省第四人民医院呼吸与危重症医学科就诊的COPD合并活动性肺结核患者纳入研究,并纳入同期COPD对照组、结核对照组及常规对照组患者,比较四组患者的年龄、性别、肺功能等一般资料,比较并分析患者外周血自然杀伤细胞(NK细胞)、T淋巴细胞亚群及细胞因子的表达水平,并对患者肺功能与T淋巴细胞亚群及细胞因子表达水平间的相关性进行分析。结果四组患者年龄、吸烟史、肺功能、NK细胞表达率、CD4^(+)T淋巴细胞、CD8^(+)T淋巴细胞水平及CD4^(+)/CD8^(+)比值间存在显著差异(均P<0.05),COPD合并结核患者SIL-2R、IL-6、IFN-γ及TNF-α水平显著高于COPD患者(均P<0.05);患者FEV1水平与SIL-2R、TNF-α及IL-6水平呈负相关(r=-0.476,-0.487,-0.596;均P<0.05)。结论COPD合并活动性肺结核患者SIL-2R、IL-6、IFN-γ及TNF-α水平显著升高,且SIL-2R、TNF-α及IL-6水平升高与患者FEV1恶化相关。Objective To analyze the correlation between FEV1 level and serum cytokine levels in patients with chronic obstructive pulmonary disease(COPD)complicated with active tuberculosis infection,and to provide theoretical evidence for clinical intervention.Method Patients with COPD combined with active tuberculosis infection admitted to the department of respiratory and critical care medicine of the fourth people's hospital of Shaanxi province from January 2019 to April 2022 were included in the study,and patients with COPD control group,tuberculosis control group and conventional control group were included in the same period.General data such as age,gender and lung function of the four groups were compared.The expression levels of natural killer cells(NK),T lymphocyte subsets and cytokines in peripheral blood of patients were compared and analyzed,and the correlation between lung function and T lymphocyte subsets and cytokine expression levels was analyzed.Result There were statistically significant differences in age,smoking history,lung function,NK expression rate,CD4^(+)T lymphocyte level,CD8^(+)T lymphocyte level and CD4^(+)/CD8^(+)ratio among 4 groups of patients(all P<0.05),the levels of SIL2R,IL-6,IFN-γand TNF-αwere significantly higher in COPD patients with tuberculosis than in COPD patients(P<0.05);The levels of FEV1 were negatively correlated with the levels of Sil2R,TNF-αand IL-6(r=-0.476,-0.487,-0.596;P<0.05).Conclusion The levels of SIL-2R,IL-6,IFN-γand TNF-αin COPD patients with active tuberculosis infection were significantly increased,and the increased levels of SIL-2R,TNF-αand IL-6 were significantly correlated with the deterioration of FEV1.

关 键 词：慢性阻塞性肺疾病 活动性肺结核 肺功能 T淋巴细胞亚群 细胞因子 相关性 

分 类 号：R563[医药卫生—呼吸系统] R52[医药卫生—内科学]