血清MCP-1水平及外周血Th17/Treg平衡与老年COPD并发全身炎症反应综合征的关系  

Relationships of serum MCP-1 levels and Th17/Treg cell balance with COPD complicated with SIRS in the elderly

作　　者：殷俏 何新霞[1] 王晶[2] 马瑞晓 YIN Qiao;HE Xinxia;WANG Jing;MA Ruixiao(Department of General Medicine,Hebei Hengshui People's Hospital(Harrison International Peace Hospital),Hengshui 053000,China;不详)

机构地区：[1]河北衡水市人民医院(哈励逊国际和平医院)全科医学科,河北衡水053000 [2]河北衡水市人民医院(哈励逊国际和平医院)呼吸与危重症科 [3]河北衡水市人民医院(哈励逊国际和平医院)感染性疾病科

出　　处：《山东医药》2024年第16期15-18,共4页Shandong Medical Journal

基　　金：河北省医学科学研究课题计划(20232189)。

摘　　要：目的探讨血清单核细胞趋化蛋白-1(MCP-1)水平及外周血辅助性T细胞17(Th17)/调节性T细胞(Treg)平衡与老年慢性阻塞性肺疾病(COPD)并发全身炎症反应综合征(SIRS)的关系。方法选取82例老年COPD合并SIRS患者(SIRS组),以1∶1比例对照选取单纯老年COPD患者(非SIRS组)。采用酶联免疫吸附法与流式细胞术检测血清MCP-1与外周血Th17、Treg比例。通过多因素Logistic回归分析老年COPD并发SIRS的影响因素,受试者工作特征(ROC)曲线分析血清MCP-1水平和外周血Th17/Treg对老年COPD并发SIRS的预测价值。结果与非SIRS组比较,SIRS组血清MCP-1和外周血Th17、Th17/Treg高,外周血Treg比例低(P<0.05)。Th17高(OR=3.640,95%CI:1.929~6.867)、MCP-1高(OR=1.035,95%CI:1.016~1.054)、Th17/Treg高(OR=3.612,95%CI:1.835~7.107)为老年COPD并发SIRS的独立危险因素,Treg高(OR=0.651,95%CI:0.467~0.907)为独立保护因素(P<0.05)。血清MCP-1水平联合外周血Th17/Treg预测老年COPD并发SIRS的曲线下面积为0.890(95%CI:0.832~0.934),大于血清MCP-1水平、外周血Th17/Treg单独预测(P均<0.05)。结论血清MCP-1水平升高和Th17/Treg失衡与老年COPD并发SIRS独立相关,血清MCP-1水平联合外周血Th17/Treg检测对老年COPD并发SIRS有较高的预测价值。Objective To investigate the relationships of serum monocyte chemotactic protein-1(MCP-1)level and T helper cells 17(Th17)/T regulatory cells(Treg)cellular balance with chronic obstructive pulmonary disease(COPD)complicated with systemic inflammatory response syndrome(SIRS)in the elderly.Methods Eighty-two elderly patients with COPD combined with SIRS(SIRS group)were selected,and elderly patients with COPD alone(non-SIRS group)were selected at the case-control ratio of 1∶1.Serum MCP-1 levels and the ratio of Th17 and Treg were measured by enzyme-linked immunosorbent assay and flow cytometry.Logistic regression was used to analyze the factors for COPD com-plicated with SIRS in the elderly,and ROC curves were used to analyze the predictive value of serum MCP-1 and peripheral blood Th17/Treg for COPD complicated with SIRS in the elderly.Results Compared with the non-SIRS group,serum MCP-1 and peripheral blood Th17 and Th17/Treg increased,and the peripheral blood Treg ratio decreased in the SIRS group(all P<0.05).Th17(OR=3.640,95%CI:1.929 to 6.867),MCP-1(OR=1.035,95%CI:1.016 to 1.054),elevated Th17/Treg(OR=3.612,95%CI:1.835 to 7.107)were independent risk factors for COPD complicated with SIRS in the elderly,and elevated Treg(OR=0.651,95%CI:0.467 to 0.907)was an independent protective factor(P<0.05).The area under the curve of serum MCP-1 combined with peripheral blood Th17/Treg in predicting COPD compli-cated with SIRS in the elderly was 0.890(95%CI:0.832 to 0.934),which was greater than that of serum MCP-1[0.786(95%CI:0.715 to 0.846)]and peripheral blood Th17/Treg[0.815(95%CI:0.747 to 0.871)]alone,respectively(both P<0.05).Conclusion The elevated serum MCP-1 level and Th17/Treg cellular imbalance were independently associated with COPD complicated with SIRS in the elderly,and serum MCP-1 combined with peripheral blood Th17/Treg had a high predictive value for COPD complicated with SIRS in the elderly.

关 键 词：慢性阻塞性肺疾病 单核细胞趋化蛋白-1 辅助性T细胞17/调节性T细胞 全身炎症反应综合征 老年人 

分 类 号：R563[医药卫生—呼吸系统]