慢性阻塞性肺疾病患者肺泡灌洗液中sIgA与血清总IgA、T淋巴细胞亚群的相关性分析  

Correlation analysis of sIgA in alveolar lavage fluid with serum total IgA and T lymphocyte subsets in patients with chronic obstructive pulmonary disease

作　　者：杨勇[1] 唐琦 常晓悦[1] YANG Yong;TANG Qi;CHANG Xiaoyue(Department of Respiratory and Critical Care Medicine,Baotou Central Hospital,Baotou 014040,China;Department of Respiratory Medicine,the First People's Hospital of Kerqin District)

机构地区：[1]包头市中心医院呼吸与危重症医学科,内蒙古包头014040 [2]通辽市科尔沁区第一人民医院呼吸内科

出　　处：《包头医学院学报》2024年第8期69-76,共8页Journal of Baotou Medical College

基　　金：包头市应用技术研发资金(2016X1030-1-5)。

摘　　要：目的:比较慢性阻塞性肺疾病(chronic obstructive pulmonary disease,COPD)、肺炎及正常人在肺泡灌洗液中分泌型免疫球蛋白A(sIgA)、免疫球蛋白A(IgA)及血液中T淋巴细胞亚群的差异,探讨检测肺泡灌洗液sIgA、血清IgA及血液中T淋巴细胞亚群的临床意义。方法:收集2018年12月至2020年3月包头市中心医院呼吸与危重症医学科住院患者及包头市中心医院健康体检中心体检健康人员。慢性阻塞性肺疾病合并肺炎组(COPD-P组)29人,单纯慢性阻塞性肺疾病组(S-COPD组)26例,单纯肺炎组(S-P组)27例,体检健康人员为对照组(CG组)27例。收集肺泡灌洗液检测sIgA和血清中IgA、CD4^(+)T细胞百分数、CD8^(+)T细胞百分数、T淋巴细胞绝对数,CD4^(+)T/CD8^(+)T的比值等数据。运用SPSS 20.0软件进行数据分析。结果:4组间血清IgA、T淋巴细胞绝对数、CD4^(+)T细胞百分数差异无统计学意义(P>0.05);4组间sIgA水平、CD4^(+)T细胞/CD8^(+)T细胞比值、CD8^(+)T细胞百分数差异具有统计学意义(P<0.05)。结论:在S-COPD和COPD-P患者的肺泡灌洗液中sIgA含量明显降低,提示黏膜表面缺乏sIgA导致了黏膜屏障受损。感染与黏膜表面的sIgA缺乏相关,黏膜的sIgA缺乏可能是COPD感染机会增多的原因之一。在COPD患者血清中的CD8^(+)T细胞增高,CD4^(+)T细胞/CD8^(+)T细胞比值的失衡在COPD患者中普遍存在,提示细胞免疫存在功能紊乱。在COPD中检测T淋巴细胞亚群,把CD4^(+)T/CD8^(+)T细胞的比值作为预测T淋巴细胞亚群内部细胞组成成分紊乱的指标之一,具有提示效应。Objective:To explore the clinical significance of sIgA in alveolar lavage fluid,serum IgA and blood T lymphocyte subsets in patients with chronic obstructive pulmonary disease,pneumonia and healthy people by comparing their differences.Methods:The inpatients from the Department of Respiratory and Critical Care Medicine of Baotou Central Hospital and the health personnel from the Health examination Center of Baotou Central Hospital from December 2018 to March 2020 were collected.There were 29 patients with chronic obstructive pulmonary disease combined with pneumonia(COPD-P group),26 patients with simple chronic obstructive pulmonary disease(S-COPD group),27 patients with simple pneumonia(S-P group),and 27 health personnel in the control group(CG group).sIgA and serum levels of IgA,CD4^(+)T cells,CD8^(+)T cells,absolute number of T lymphocytes,CD4^(+)T/CD8^(+)T ratio and other data were detected in alveolar lavage fluid.SPSS 20.0 software was used for data analysis.Results:There was no significant difference in serum IgA,T lymphocyte absolute number and CD4^(+)T cell percentage among the four groups(P>0.05).sIgA level,CD4^(+)T cell/CD8^(+)T cell ratio,and percentage of CD8^(+)T cell were significantly different among the four groups(P<0.05).Conclusion:sIgA content in alveolar lavage fluid was significantly reduced in patients with S-COPD and COPD P,suggesting that the lack of sIgA on the mucosal surface caused mucosal barrier damage.Infection is associated with a lack of sIgA on the mucosal surface,which may be one of the reasons for the increased chance of COPD infection.The level of CD8^(+)T cells in the serum of COPD patients increased,and the imbalance of the ratio of CD4^(+)T cells/CD8^(+)T cells was common in COPD patients,indicating the dysfunction of cellular immunity.In COPD,the ratio of CD4^(+)T/CD8^(+)T cells was used as one of the indicators to predict the disturbance of the internal cell composition of T lymphocyte subsets,which has a suggestive effect.

关 键 词：慢性阻塞性肺疾病 肺炎 肺泡灌洗液 分泌性免疫球蛋白A T淋巴细胞亚群 

分 类 号：R563.9[医药卫生—呼吸系统]