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目的:探讨老年慢性阻塞性肺疾病(COPD)患者疾病进展与机体调节性T细胞(Treg)的关系。方法:选取我院收治的65例COPD患者(COPD组)以及同期在我院行体检的健康人群45例(正常对照组),将COPD患者分为急性期组41例及稳定期组24例,采用肺功能仪检测肺功能,采用酶联免疫吸附法检测血清γ-干扰素(IFN-γ)、白介素4(IL-4)、IL-17水平,采用流式细胞仪检测外周血CD4+CD25+Treg细胞比例。结果:与正常对照组比较,COPD患者的FEV1、FVC、PEF、FEV1/FVC、6MWT、血清IL-4水平、外周血CD4~+CD25~+Treg细胞比例均明显下降,血清IFN-γ、IL-17及Th1/Th2均显著升高。急性期COPD患者的CD4~+CD25~+Treg细胞比例较正常对照组显著升高,而正常对照组患者的CD4~+CD25~+Treg细胞比例较稳定组COPD患者显著升高,组间比较均有明显差异(P<0.05)。结论:老年CODP患者体内存在免疫功能失调,调节性T细胞可能参与了老年COPD疾病的发病以及急性加重过程,导致患者出现肺功能改变。
Objective: To investigate the relationship between the disease progression and the regulatory T cells (Treg) in elderly patients with chronic obstructive pulmonary disease (COPD). Methods: A total of 65 patients with COPD (COPD group) and 45 healthy subjects (normal control group) undergoing physical examination in our hospital were enrolled. COPD patients were divided into acute group (41 cases) and stable group (24 cases) Pulmonary function tests were performed to detect the lung function. Serum levels of IFN-γ, IL-4 and IL-17 were detected by enzyme-linked immunosorbent assay. Flow cytometry was used to detect the levels of CD4 + CD25 + Treg cell ratio. Results: Compared with the normal control group, the proportion of FEV1, FVC, PEF, FEV1 / FVC, 6MWT, serum IL-4 and CD4 ~ + CD25 ~ + Treg cells in COPD patients were significantly decreased -17 and Th1 / Th2 were significantly increased. The percentage of CD4 ~ + CD25 ~ + Treg cells in patients with acute COPD was significantly higher than that in the control group, while the percentage of CD4 ~ + CD25 ~ + Treg cells in the control group was significantly higher than that in the stable patients There was a significant difference (P <0.05). Conclusion: Immune dysfunction exists in elderly patients with CODP. Regulatory T cells may be involved in the pathogenesis and acute exacerbation of COPD in elderly patients, resulting in pulmonary function changes.