论文部分内容阅读
目的评价吸烟对慢性阻塞性肺疾病(chronic obstructive pulmonary disease,COPD)患者急性加重期和稳定期气道局部炎症的影响。方法根据吸烟史将患者分为无吸烟史的对照组(A组)、无吸烟史COPD组(B组)、持续吸烟的COPD组(C组)和已戒烟的COPD组(D组);分别在急性加重期和稳定期收集支气管肺泡灌洗液(bronchoalveolar lavage fluid,BALF);流式细胞术检测各组患者BALF中CD3+、CD4+、CD8+T淋巴细胞数,ELISA法检测BALF中肿瘤坏死因子(tumor necrosis factor,TNF)-α及干扰素(nterferon,IFN)-γ水平,并计算CD4+/CD8+T细胞比例。结果 1.与非吸烟对照组比较,急性加重期和稳定期各组COPD患者BALF中CD4+细胞减少,而CD8+T细胞增加,因此CD4+/CD8+T细胞比例下降;同时TNF-α和IFN-γ水平均明显上升;2.在急性加重期,与非吸烟和已戒烟COPD患者比较,持续吸烟COPD患者BALF中CD4+T细胞下降,而CD8+T细胞比例上升,因而CD4+/CD8+T细胞比例下降,而TNF-α和IFN-γ水平显著升高;3.在稳定期,与非吸烟和已戒烟COPD患者比较,持续吸烟COPD患者BALF中CD4+和CD8+T细胞数无明显差异,但CD4+/CD8+比例稍下降,而TNF-α和IFN-γ水平显著升高。结论持续吸烟的COPD患者在急性加重期和稳定期气道局部炎症存在差异,主要是CD8+T细胞的反应差异。
Objective To evaluate the effect of smoking on acute regional airway inflammation in patients with chronic obstructive pulmonary disease (COPD). Methods According to smoking history, the patients were divided into control group without smoking history (group A), non-smoking history COPD group (group B), persistent smoking group (group C) and quitting smoking group (group D) Bronchoalveolar lavage fluid (BALF) was collected in acute exacerbation and stable periods. The numbers of CD3 +, CD4 + and CD8 + T lymphocytes in BALF of each group were detected by flow cytometry. Tumor necrosis factor Tumor necrosis factor (TNF) -α and nterferon (IFN) -γ, and calculate the proportion of CD4 + / CD8 + T cells. Compared with non-smoking control group, the percentage of CD4 + / CD8 + T cells in BALF decreased and the percentage of CD4 + / CD8 + T cells decreased in COPD patients in acute exacerbation and stable phases, γ levels were significantly increased; 2. In acute exacerbation, compared with non-smokers and those who had quit smoking, COPD patients with persistent smoking decreased CD4 + T cells in BALF, while the proportion of CD8 + T cells increased, and thus CD4 + / CD8 + T cells The proportion of CD4 + and CD8 + T cells in BALF of patients with persistent COPD was significantly lower than that of nonsmokers and non-smokers with COPD, but the levels of TNF-αand IFN-γwere significantly increased.3. The proportion of CD4 + / CD8 + decreased slightly while the levels of TNF-α and IFN-γ increased significantly. CONCLUSIONS: COPD patients with persistent smoking have differences in airway local inflammation in acute exacerbation and stable phases, mainly in response to CD8 + T cells.