摘要
目的分析调节性T细胞(regulatory T cell,Treg)/辅助性T细胞17(T helper cell 17,Th17)及树突细胞(dendritic cell,DC)水平在慢性阻塞性肺疾病(chronic obstructive pulmonary disease,COPD)不同疾病进展期的表达及与预后的关系。方法选择2019年9月至2023年2月我院收治的73例COPD患者为对象,35例急性加重期为观察组,38例稳定期为对照组,比较两组CT影像参数[支气管壁面积百分比(percentage of wall area,WA%)、支气管管腔面积(bronchial lumen area,Ai)]、Treg、Th17、Treg/Th17及DC细胞水平;通过Spearman相关系数分析Treg、Th17、Treg/Th17及DC细胞水平与COPD病情严重程度之间的相关性;随访6个月,比较不同预后患者资料[包括性别、年龄、体质量指数(body mass index,BMI)、病程、基础疾病]及Treg、Th17、Treg/Th17及DC细胞;以ROC分析Treg、Th17、Treg/Th17及DC细胞判断预后不良。结果观察组Ai(8.76±2.45)mm^(2)低于对照组(14.97±3.61)mm2,WA%(77.62±7.74)%高于对照组(66.81±7.04)%(P<0.05)。观察组Treg(2.59±0.54)%、Treg/Th17(0.41±0.11)、DC细胞水平(1.38±0.41)%低于对照组(4.38±0.77)%、(0.82±0.26)、(2.52±0.82)%,观察组Th17水平(6.28±0.99)%高于对照组(5.32±0.63)%(P<0.05)。Treg、Treg/Th17、DC细胞与病情严重程度呈负相关(r=-0.563、-0.571、-0.536,P<0.05),Th17与病情严重程度呈正相关(r=0.542,P<0.05)。随访6个月,预后良好59例,预后不良14例。预后良好者Treg(3.87±1.22)%、Treg/Th17(0.69±0.21)、DC细胞水平(2.33±0.52)%高于预后不良者(2.38±0.75)%、(0.34±0.11)、(1.92±0.32)%,Th17水平(5.64±1.15)%低于预后不良者(6.91±1.42)%(P<0.05)。ROC结果显示,Treg、Th17、Treg/Th17及DC细胞判断预后不良的曲线下面积分别为0.856、0.702、0.825、0.790,P<0.05。结论Treg/Th17及DC细胞水平在COPD稳定期及急性加重期呈高表达,Treg/Th17、DC细胞水平升高对COPD的预后具有意义。
Objective To analyze the expression of regulatory T cells(Treg)/T helper cells 17(Th17)and dendritic cells(DC)in different progression stages of chronic obstructive pulmonary disease(COPD)and their relationships with prognosis.Methods The clinical data of 73 patients with COPD admitted to Suzhou Jiulong Hospital,Shanghai Jiaotong University School of Medicine from September 2019 to February 2023 were retrospectively analyzed.Among them,35 patients in the acute exacerbation stage were included in the observation group,and 38 patients in the stable stage were included in the control group.The levels of CT image parameters[percentage of wall area(WA%),bronchial lumen area(Ai)],Treg,Th17,Treg/Th17 and DC cells were detected,and the patients was divided into good prognosis(77 cases)and poor prognosis(18 cases)according to the follow-up results.The levels of Treg,Th17,Treg/Th17 and DC cells in stable group,exacerbation group and control group were compared;Spearman correlation coefficient was used to analyze the correlation between the levels of Treg,Th17,Treg/Th17,DC cells and the severity of COPD;the general data[including sex,age,body mass index(BMI),course of disease,underlying diseases]and the levels of Treg,Th17,Treg/Th17 and DC cells of the good prognosis group and the poor prognosis group were compared;ROC analysis was used to analyze the value of Treg,Th17,Treg/Th17 and DC cells in evaluating the poor prognosis of patients.Results The Ai[(8.76±2.45)mm^(2)]of the observation group was significantly lower than that of the control group[(14.97±3.61)mm2],and the WA%(77.62±7.74)%was significantly higher than that of the control group[(66.81±7.04)%](P<0.05).The levels of Treg,Treg/Th17 and DC cells in observation group[(2.59±0.54)%,(0.41±0.11),(1.38±0.41)%]were significantly lower than those in control group[(4.38±0.77)%,(0.82±0.26),(2.52±0.82)%],and the levels of Th17 in observation group[(6.28±0.99)%]were significantly higher than those in control group[(5.32±0.63)%](P<0.05).Treg,Treg/Th17 and DC cells were negatively correlated with the severity of the disease(r=-0.563,-0.571,-0.536,P<0.05),and Th17 was positively correlated with the severity of the disease(r=0.542,P<0.05).The levels of Treg,Treg/Th17 and DC cells in the good prognosis group[(3.87±1.22)%,(0.69±0.21),(2.33±0.52)%]were significantly higher than those in the poor prognosis group[(2.38±0.75)%,(0.34±0.11),(1.92±0.32)%],and the level of Th17 in the good prognosis group[(5.64±1.15)%]was significantly lower than that in the poor prognosis group[(6.91±1.42)%](P<0.05).ROC results showed that the area under the curve of Treg,Th17,Treg/Th17 and DC cells to evaluate the poor prognosis of patients was 0.856,0.702,0.825 and 0.790,respectively(P<0.05).Conclusion The levels of Treg/Th17 and DC cells were highly expressed in both stable and acute exacerbations of COPD,and the levels of Treg/Th17 and DC cells in the good prognosis group were significantly higher than those in the poor prognosis group.
作者
王丹
李文思
成苏杭
吉泽
朱祥
郝春艳
Wang Dan;Li Wensi;Cheng Suhuang;Ji Ze;Zhu Xiang;Hao Chunyan(Department of Respiratory and Critical Care Medicine,Suzhou Kowloon Hospital,Shanghai Jiao Tong University School of Medicine,Suzhou 215028,China)
出处
《中华肺部疾病杂志（电子版）》
2024年第5期685-689,共5页
Chinese Journal of Lung Diseases(Electronic Edition)
基金
上海市科学技术委员会科研计划资助项目(19401933200)。
