单核细胞表面人类白细胞抗原DR表达水平与慢性阻塞性肺疾病急性期感染的相关性研究  

Relationship between the expression of human leukocyte antigen DR on monocytes and acute exacerbation of chronic ob⁃structive pulmonary disease

作　　者：戈立秀 杨静[2] 张爱民[1] 贾晓冬 高巧营[1] 关鑫[2] 余剑波[4] 史佳[4] Ge Lixiu;Yang Jing;Zhang Aimin;Jia Xiaodong;Gao Qiaoying;Guan Xin;Yu Jianbo;Shi Jia(Department of Clinical Laboratory,Tianjin Nankai Hospital,Tianjin 300100,China;Institute of Acute Abdominal Diseases of Integrated Traditional Chinese and Western Medicine,Tianjin Nankai Hospital,Tianjin 300100,China;Tianjin Kingmed Center for Clinical Labora-tory,Tianjin 300384,China;Department of Anesthesiology and Critical Care Medicine,Tianjin Nankai Hospital,Tianjin 300100,China)

机构地区：[1]天津市南开医院检验科,天津300100 [2]天津市南开医院中西医结合急腹症研究所,天津300100 [3]天津金域医学检验实验室有限公司,天津300384 [4]天津市南开医院麻醉科和重症医学科,天津300100

出　　处：《国际麻醉学与复苏杂志》2024年第1期47-52,共6页International Journal of Anesthesiology and Resuscitation

基　　金：天津市科技计划项目(21JCYBJC01240);天津市卫生健康委员会中医中西医结合科研课题(2021093)。

摘　　要：目的探讨人外周血单核细胞表面人类白细胞抗原DR(HLA⁃DR)表达水平与慢性阻塞性肺疾病(COPD)急性期感染的相关性。方法选取天津市南开医院慢性阻塞性肺疾病急性加重(AECOPD)患者和体检健康者共37例,根据临床症状及感染指标分为对照组(15例)、急性期组(临床治疗干预前,22例)和稳定期组(临床干预后,16例)。采集患者外周静脉血,用流式细胞仪分析CD14^(+)单核细胞HLA⁃DR的表达水平,并与患者C反应蛋白(CRP)、白细胞计数、中性粒细胞百分比、中性粒细胞计数、CD3^(+)T细胞百分比、CD3^(+)CD4^(+)T细胞百分比、CD3^(+)CD8^(+)T细胞百分比和CD4^(+)/CD8^(+)等进行相关性分析。结果与对照组比较,急性期组患者外周静脉血CD14^(+)单核细胞HLA⁃DR的表达水平降低(P<0.05)。与急性期组比较,稳定期组患者外周静脉血CD14^(+)单核细胞HLA⁃DR的表达水平升高(P<0.05),CRP的水平降低(P<0.05),白细胞计数、中性粒细胞百分比、中性粒细胞计数下降(均P<0.05),CD3^(+)CD4^(+)T细胞百分比、CD4^(+)/CD8^(+)增加(均P<0.05),CD3^(+)T细胞百分比、CD3^(+)CD8^(+)T细胞百分比无明显变化(均P>0.05)。相关性分析发现,急性期组患者外周静脉血CD14^(+)单核细胞HLA⁃DR的表达水平与CRP呈负相关,与CD3^(+)CD4^(+)T细胞百分比和CD4^(+)/CD8^(+)呈正相关。结论AECOPD患者CD14^(+)单核细胞HLA⁃DR表达水平降低,可作为评估患者免疫状态的辅助指标。Objective To investigate the relationship between the expression of leukocyte antigen DR(HLA⁃DR)on mono⁃cytes and acute exacerbation of chronic obstructive pulmonary disease(COPD).Methods A total of 37 patients with acute exacer⁃bation of COPD(AECOPD)who were admitted to Tianjin Nankai Hospital and healthy persons for physical examination were selected.According to their clinical symptoms and infection indicators,the patients were divided into three groups:a healthy control group(n=15),an acute group(n=22,before clinical treatment intervention)and a stable group(n=16,after clinical intervention).Their peripheral blood samples were collected,and the expression of HLA⁃DR on CD14^(+)monocytes was detected by flow cytometry.Their relationships with C⁃reactive protein(CRP),white blood cell count,neutrophil percentage,neutrophil count,CD3^(+)T lymphocyte percentage,CD3^(+)CD4^(+)T lymphocyte percentage,CD3^(+)CD8^(+)T lymphocyte percentage and CD4^(+)/CD8^(+)were analyzed.Results Compared with the healthy control group,patients in the acute group showed remarkable decreases in the levels of HLA⁃DR on CD14^(+)monocytes(P<0.05).Compared with the acute group,the stable group presented significant increases in the expression of HLA⁃DR on CD14^(+)mono⁃cytes(P<0.05),decreases in CRP levels(P<0.05),white blood cell count,neutrophil percentage and neutrophil count(all P<0.05),and increases in CD3^(+)CD4^(+)T cell percentage,and CD4^(+)/CD8^(+)(all P<0.05).In contrast,no significant changes were found in the percentage of CD3^(+)T lymphocytes and the percentage of CD3^(+)CD8^(+)T lymphocytes(all P>0.05).Correlation analysis indicated that,the expression of HLA⁃DR on CD14^(+)monocytes in the peripheral venous blood of the acute group was negatively correlated with CRP,but positively correlated with the percentage of CD3^(+)CD4^(+)T lymphocytes and CD4^(+)/CD8^(+).Conclusions The expression of HLA⁃DR on CD14^(+)monocytes in AECOPD patients is reduced,which can be used as an auxiliary indicator to evaluate the

关 键 词：慢性阻塞性肺疾病 单核细胞 人类白细胞抗原DR C反应蛋白 

分 类 号：R563.9[医药卫生—呼吸系统]