慢性阻塞性肺疾病患者外周血T、B及NK细胞变化研究

发布时间：2018-07-10 03:09

本文选题：COPD + T细胞　；参考：《吉林大学》2012年硕士论文

【摘要】：背景：慢性阻塞性肺疾病（chronic obstructive pulmonary diseases，COPD）是一种气流受限为特征的肺部疾病，气流受限不完全可逆、呈进行性发展，确切的病因还不十分清楚，但认为与肺部对有害气体或有害颗粒的异常炎症反应有关。已发现的危险因素包括吸烟、空气污染、呼吸道感染等外部因素和气道高反应性等内部因素。COPD患者经常反复发病，随着病情发展而逐渐加重进而产生肺源性心脏病，导致呼吸衰竭及心力衰竭。感染是COPD患者急性发病的一个重要原因，免疫功能异常更易引起感染的发生，近年来COPD患者淋巴细胞功能异常受到重视，T淋巴细胞亚群、B细胞及NK细胞水平异常可能在COPD发生、发展和预后起重要作用。但直到今天，COPD患者外周血T淋巴细胞亚群、B细胞及NK细胞的变化并没有统一结论，COPD患者肺功能异常，反复发病加重肺功能损伤，通气和换气功能障碍导致病人活动受限，严重影响正常的生产、生活。目的：通过检测COPD患者外周血T、B及NK细胞的变化，探讨COPD患者免疫功能紊乱情况，为COPD患者的免疫调节治疗提供理论支持，并分析T、B、NK细胞与肺功能FEV1/FVC的关系。方法：选取40例COPD患者，健康对照组20例。分别比较COPD急性加重期与对照组、急性加重期与稳定期、稳定期与对照组的T细胞亚群、B细胞和NK细胞的差异，并分析急性发作期T细胞亚群、B细胞和NK细胞与肺功能的关系。结果： 1、COPD急性加重期患者与健康对照人群比较，，外周血CD3+、CD4+、CD4+/CD8+、NK、B降低，差异有统计学意义（P0.05）；CD8+升高，但差异没有统计学意义（P0.05）； 2、COPD患者稳定期与急性加重期相比，CD3+、CD4+、CD4+/CD8+、NK、B升高，但均无统计学意义（P0.05）；CD8+下降，但差异没有统计学意义； 3、COPD稳定期患者与对照组比较CD3+、CD4+、CD4+/CD8+、NK、B降低，差异有统计学意义（P0.05）；CD8+升高，差异无统计学意义（P0.05）； 4、COPD患者急性加重期CD4+T淋巴细胞、CD4+/CD8+、NK细胞与肺功能指标FEV1/FVC呈正相关。结论： 1、COPD患者存在免疫功能紊乱，细胞免疫和体液免疫下降，以急性加重期明显； 2、COPD患者经治疗达到稳定期后，免疫功能较急性加重期提高，但与健康对照组相比仍明显降低，提示稳定期免疫功能仍存在紊乱，未完全恢复正常水平； 3、COPD患者肺功能下降，本试验表明免疫功能降低与肺功能下降有相关性，这方面有待进一步研究。
[Abstract]:Background: chronic obstructive pulmonary disease (chronic obstructive pulmonary) is a pulmonary disease characterized by airflow limitation. But it is associated with abnormal inflammation of lungs to harmful gases or particles. The risk factors identified include smoking, air pollution, respiratory tract infection, and internal factors such as airway hyperresponsiveness. Patients with COPD often develop recurrent diseases, which gradually worsen with the development of the disease and lead to pulmonary heart disease. Causes respiratory failure and heart failure. Infection is an important cause of acute onset of COPD, and the abnormal immune function is more likely to cause infection. In recent years, the abnormal level of T lymphocyte subsets B cells and NK cells in COPD patients may occur in COPD. Development and prognosis play an important role. Up to now, however, the changes of T lymphocyte subsets B cells and NK cells in peripheral blood of COPD patients have not unified conclusion: pulmonary function is abnormal in COPD patients, recurrent occurrence exacerbates lung function damage, and ventilation dysfunction lead to limited activity of patients. Seriously affect the normal production, life. Objective: to investigate the immune dysfunction in patients with COPD by detecting the changes of T B and NK cells in peripheral blood of COPD patients, to provide theoretical support for immunomodulatory therapy of COPD patients, and to analyze the relationship between Tnk B B NK cells and FEV 1 / FVC of lung function. Methods: 40 COPD patients and 20 healthy controls were selected. The difference of T cell subgroup B cells and NK cells between acute exacerbation stage and control group, acute exacerbation phase and stable phase, stable phase and control group was compared, and the relationship between T cell subgroup B cell and NK cell and lung function was analyzed. Results: (1) compared with the healthy control group, the CD3 CD 4 / CD 8 / CD 8 NKB decreased significantly (P0.05), but the difference was not statistically significant (P0.05) in patients with acute exacerbation of COPD, but there was no significant difference between them (P0.05). 2in the stable stage of COPD patients, the CD4 / CD8 ratio of the patients with COPD was higher than that of the patients with acute exacerbation, but there was no significant difference in CD8 between them (P0.05), but there was no significant difference between the stable stage patients with COPD and the patients with acute exacerbation, 3The CD4 / CD8 ratio of NKB in the patients with stable COPD was lower than that in the control group, and there was no significant difference between the patients with COPD and the control group. The difference was statistically significant (P0.05) and the difference was not statistically significant (P0.05). 4 in COPD patients with acute exacerbation stage CD4 / CD8 NK cells were positively correlated with the pulmonary function index FEV1 / FVC. Conclusion: (1) the patients with COPD have immune dysfunction, cellular immunity and humoral immunity decrease, especially in acute exacerbation stage, 2the immune function of COPD patients after treatment reaches stable stage, and the immune function is higher than that in acute exacerbation stage, and the immune function of COPD patients is higher than that of acute exacerbation stage. However, compared with the healthy control group, the immune function was still in disorder and did not return to normal level in the stable phase, and the pulmonary function of COPD patients was decreased, which indicated that the decrease of immune function was related to the decrease of pulmonary function. This aspect needs further study.
【学位授予单位】：吉林大学
【学位级别】：硕士
【学位授予年份】：2012
【分类号】：R563.9

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