不同分期慢性阻塞性肺病患者T淋巴细胞亚群细胞因子变化及其与肺功能的相关性研究  

Changes in T lymphocyte-released cytokines in different COPD stages and their correlation with pulmonary function

作　　者：郝小梅[1] 彭文照 刘梅[2] 

机构地区：[1]广东省第二中医院 [2]广州中医药大学基础医学院,广东广州510006

出　　处：《广州医科大学学报》2018年第1期7-10,共4页Academic Journal of Guangzhou Medical University

基　　金：广东省医学科研基金资助项目(20152011);广东省中医药局建设中医药强省科研课题(20152011);广东省高水平大学建设资助项目

摘　　要：目的:探讨缓解期、急性期慢性阻塞性肺病(COPD)患者外周血T淋巴细胞亚群Th17、Treg、Th17/Treg、IL-22、Th22细胞因子的变化及与肺功能之间的相关性。方法:选取2016年7月-2017年7月广东省第二中医院,广东省中医院呼吸内科门诊和住院治疗的COPD患者80例,缓解期组与急性期组各40例,同期体检正常未患COPD者20例设为对照组。检测比较3组间Th17细胞分数、Treg细胞分数、Th17细胞/Treg细胞比值、IL-22+细胞分数、Th22细胞分数,肺功能指标FEV1%、FVC%、FEV1/FVC的变化,并分析T淋巴细胞亚群细胞因子与不同分期COPD患者的关系及与肺功能指标的相关性。结果:急性期组COPD患者外周血Th17细胞分数、Th17细胞/Treg细胞比值、Th22细胞分数、IL-22+细胞分数均高于对照组与缓解期组(P<0.05),Treg细胞分数低于于对照组与缓解期组(P<0.05)。缓解期组COPD患者外周血Th17细胞分数、Th17细胞/Treg细胞比值、Th22细胞分数、IL-22+细胞分数均高于对照组,Treg细胞分数低于对照组(P<0.05)。急性期组受试者FEV1%、FEV1/FVC低于对照组与缓解期组(P<0.05),缓解期组受试者FEV1%、FEV1/FVC低于对照组(P<0.05)。外周血Treg细胞分数与FEV1%、FEV1/FVC呈正相关(P<0.01),Th17细胞分数、Th17/Treg细胞比值、Th22细胞分数、IL-22+细胞分数与FEV1%、FEV1/FVC呈负相关(P<0.01)。结论:COPD患者T淋巴细胞亚群相关细胞因子比例失衡而导致持续存在的慢性炎性反应,自身免疫失衡与COPD肺功能损伤密切相关。Objective: To investigate the changes in cytokines released by peripheral blood T lymphocyte subsets Th17,Treg,Th17/Treg,IL-22,Th22 and their correlation with lung function in stable and exacerbated COPD patients. Methods: Between July 2016 and July 2017,80 COPD patients from the Respiratory Medicine of Clinics of Guangdong Provincial Second Hospital of Traditional Chinese Medicine and Guangdong Provincial Hospital of Traditional Chinese Medicine were included in this study( n = 40 assigned to the stable COPD group and n = 40 assigned to the exacerbated COPD group). A contemporary cohort of non-COPD health work-up subjects was recruited as the control group. The percentage counts of Th17,Treg,IL-22+ and Th22 cells,Th17/Treg ratio,lung function parameters( FEV1%,FVC%,and FEV1/FVC) were compared among the three groups.The relationship between T lymphocyte cytokines and different COPD stages and lung function parameters were analyzed. Results: The exacerbated COPD group showed significantly higher percentage counts of Th17,Th22 and IL-22+ cells,greater Th17/Treg ratio,and lower percentage count of Treg in the peripheral blood,compared with the stable COPD group and the control group( all P< 0.05). The stable COPD group showed higher percentage counts of Th17,Th22 and IL-22 + cells,greater Th17/Treg ratio,and lower percentage count of Treg cells compared with the control group( all P < 0. 05). The FEV1% and FEV1/FVC was lower in exacerbated COPD patients compared with stable COPD patients( P < 0. 05),and also in stable COPD patients compared with the controls( P < 0. 05). The peripheral blood Treg percentage count was positively correlated with FEV1% and FEV1/FVC( P<0.01); the percentage counts of peripheral Th17,Th22 and IL-22+ cells,as well as the Th17/Treg ratio,were negatively correlated with FEV1% and FEV1/FVC( P < 0. 01). Conclusion: The imbalance in cytokines released by T lymphocyte subsets in COPD patients leads to persistent chronic inflammation.Autoimmune imbalance is closely related to impaired pulmonary

关 键 词：慢性阻塞性肺病 肺功能 T淋巴细胞亚群 

分 类 号：R332[医药卫生—人体生理学]