摘要
目的探讨不同病程慢性阻塞性肺疾病(COPD)患者的细胞免疫功能和炎症因子水平。方法回顾性分析2021年1—9月于广州市增城区妇幼保健院治疗的180例COPD患者的临床资料,根据不同病程分为COPD急性加重组(n=93)与COPD稳定组(n=87),另选同期体检健康者作为对照组(n=60),比较COPD组急性加重期及稳定期与对照组的细胞免疫功能、炎症因子及肺功能水平差异,分析细胞免疫功能、炎症因子与肺功能指标的相关性,分析各指标中影响预后的相关因素。结果与对照组比较,COPD急性加重组及COPD稳定组CD3^(+)、CD4^(+)、CD4^(+)/CD8^(+)、NK细胞水平和FEV_(1)、FVC、FEV_(1)/FVC水平明显降低,TNF-α、IL-6、IL-8水平明显升高,差异具有统计学意义(P<0.05);与COPD稳定组比较,COPD急性加重组CD3^(+)、CD4^(+)、CD4^(+)/CD8^(+)、NK细胞及FEV_(1)、FVC、FEV_(1)/FVC水平降低更明显,TNF-α、IL-6、IL-8水平升高更明显(P<0.05);CD4^(+)/CD8^(+)与FEV_(1)/FVC呈正相关,TNF-α、IL-6、IL-8与FEV_(1)/FVC呈负相关(P<0.05);单因素分析显示CD4^(+)/CD8^(+)、TNF-α、FEV_(1)/FVC是预后不良的影响因素,logistic回归分析结果显示CD4^(+)/CD8^(+)、TNF-α、FEV_(1)/FVC是预后不良的独立危险因素。结论随着COPD患者病情的加重,患者相关细胞免疫功能、炎症因子及肺功能水平也随之发生变化,并影响预后。
Objective To explore the cellular immune function and inflammatory factor levels in patients with chronic obstructive pulmonary disease(COPD)in different courses.Methods A retrospective analysis of the clinical data of 180 COPD patients treated in the Guangzhou Zengcheng District Maternity and Child Health Hospital from January 2021 to September 2021 was divided into acute COPD groups(n=93)and COPD stable groups(n=87)according to the course of the disease.In addition,healthy individuals with physical examination during the same period were selected as the control group(n=60).To compare the differences in the levels of cellular immune function,inflammatory factors and lung function between the COPD group in the acute exacerbation and stable phase and the control group,and analyze the cellular immune function,The correlation between inflammatory factors and pulmonary function indexes,and analysis of related factors affecting prognosis in each index.Results Compared with the control group,the levels of CD3^(+),CD4^(+),CD4^(+)/CD8^(+),NK cells and FEV_(1),FVC and FEV_(1)/FVC decreased significantly,while the levels of TNF-α,IL-6 and IL-8 increased in COPD acute plus recombinant and stable groups(P<0.05);compared with stable COPD group,the levels of CD3^(+),CD4^(+),CD4^(+)/CD8^(+),NK cells,FEV_(1),FVC,FEV_(1)/FVC decreased more significantly,and the levels of TNF-α,IL-6 and IL-8 increased more significantly(P<0.05);CD4^(+)/CD8^(+)is positively correlated with FEV_(1)/FVC,TNF-α,IL-6,IL-8 are negatively correlated with FEV_(1)/FVC(P<0.05);univariate analysis showed that CD4^(+)/CD8^(+),TNF-α,FEV_(1)/FVC are poor prognostic factor.Logistic regression analysis results show that CD4^(+)/CD8^(+),TNF-α,FEV_(1)/FVC are independent factors for poor prognosis.Conclusion With the aggravation of COPD patients,the relevant cellular immune function,inflammatory factors and lung function levels of the patients also change,and affect the prognosis.
作者
李杰锋
缪学琼
唐艺
陈军兰
LI Jiefeng;MIAO Xueqiong;TANG Yi;CHEN Junlan(Department of Internal Medicine,Guangzhou Zengcheng Maternal and Child Health Hospital,Guangdong,Guangzhou,511300,China)
出处
《中国医药科学》
2022年第8期159-163,共5页
China Medicine And Pharmacy
基金
广东省广州市增城区科技计划项目(2021058)。
关键词
慢性阻塞性肺疾病
细胞免疫功能
炎症因子表达
肺功能
Chronic obstructive pulmonary disease
Cellular immune function
Inflammatory factor expression
Lung function
