外周血Th17细胞对慢性阻塞性肺疾病症状严重程度及预后的评估价值

发布时间：2018-03-28 21:26

本文选题：Th细胞　切入点：慢性阻塞性肺疾病　出处：《中国病理生理杂志》2016年02期

【摘要】：目的:观察Th17细胞水平与慢性阻塞性肺疾病(COPD)患者症状严重程度及预后因素的相关性,以期探讨Th17细胞水平在判断COPD临床预后方面的可能价值。方法:选取2013年5月~2014年12月我院就诊的110例COPD患者为研究对象,40例健康体检者为对照组。根据COPD全球倡议(GOLD)将COPD患者分为A组(低危、症状轻)、B组(低危、症状重)、C组(高危、症状轻)及D组(高危、症状重),给予吸入性糖皮质激素/长效β_2受体激动剂或吸入性糖皮质激素/长效β2受体激动剂+长效胆碱能药物治疗,收集患者治疗前及治疗3个月后相关临床资料,包括外周血Th17细胞比例、细胞因子(IL-17和IL-6)、慢性阻塞性肺疾病评估测试(CAT)评分、年龄、体重指数、肺功能指标及诊断前12个月COPD急性加重(AECOPD)次数,分析Th17细胞水平与其它临床特征间的相关性。结果:COPD患者外周血Th17细胞、IL-17及IL-6水平显著高于对照组(P0.05)。随着COPD症状严重程度的增加,B、D组COPD患者外周血Th17细胞、细胞因子(IL-17和IL-6)水平及CAT评分显著高于A、C组患者(P0.05)。单变量相关分析发现,治疗前B、D组外周血Th17细胞水平与CAT评分呈正相关(P0.05),而与FEV_1、FEV_1% Pred、FVC及FVC% Pred呈负相关(P0.05);A、C组外周血Th17细胞水平与CAT评分、FEV_1、FEV_1%Pred、FVC及FVC% Pred无明显相关性。治疗后外周血Th17细胞水平与CAT评分呈正相关(P0.05),而与FEV_1、FEV_1% Pred、FVC及FVC% Pred呈负相关(P0.05)。结论:外周血Th17细胞水平与COPD患者IL-17、IL-6、CAT评分及肺功能指标有较好的相关性,具有评估COPD患者症状严重程度及预后的潜在临床价值。
[Abstract]:Objective: to investigate the correlation between the level of Th17 cells and the severity of symptoms and prognostic factors in patients with chronic obstructive pulmonary disease (COPD). Methods: 110 COPD patients from May 2013 to December 2014 were selected as the study subjects and 40 healthy persons as the control group according to the global COPD. COPD patients were divided into group A (low risk, low risk). Group B (low risk), group C (high risk, mild symptom) and group D (high risk). Patients with severe symptoms were treated with inhaled glucocorticoid / long-acting 尾 _ 2 agonist or inhaled glucocorticoid / long-acting 尾 _ 2-receptor agonist with long-acting cholinergic drugs. The clinical data were collected before and after 3 months of treatment. It included peripheral blood Th17 cell ratio, cytokines IL-17 and IL-6, chronic obstructive pulmonary disease assessment test (COPD) score, age, body mass index, pulmonary function index and the number of acute exacerbations of COPD 12 months before diagnosis. Results the levels of IL-17 and IL-6 in peripheral blood Th17 cells in patients with Th17 were significantly higher than those in control group (P 0.05). With the increase of the severity of COPD symptoms, Th17 cells in peripheral blood of COPD patients in group B were significantly higher than those in control group. The levels of cytokines IL-17 and IL-6 and the CAT score were significantly higher than those in group A C (P 0.05). Univariate correlation analysis showed that the level of IL-17 and IL-6 were significantly higher than those in group A (P < 0.05). Before treatment, the level of Th17 cells in peripheral blood was positively correlated with the CAT score in group B: d, but it was negatively correlated with the CAT score of FEV1 / FEV1% PredfVC and FVC%% Pred. There was no significant correlation between the level of Th17 cells in peripheral blood and CAT score of FEV1 + FEV1 Pred FVC and FVC% Pred, and the level of Th17 cells in peripheral blood was correlated with the level of Th17 cells in peripheral blood after treatment. There was a positive correlation between CAT score and FEV1FEV1% PredfVC and FVC% Pred. Conclusion: the level of Th17 cells in peripheral blood correlates well with IL-17 IL-6 cat score and pulmonary function index in COPD patients. It has potential clinical value in evaluating the severity of symptoms and prognosis of COPD patients.
【作者单位】：重庆医科大学附属第一医院呼吸内科;
【基金】：国家临床重点专科专项经费资助课题(No.2012-649)
【分类号】：R563.9

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