本文選題：Th細(xì)胞　切入點(diǎn)：慢性阻塞性肺疾病　出處：《中國(guó)病理生理雜志》2016年02期

【摘要】：目的:觀察Th17細(xì)胞水平與慢性阻塞性肺疾病(COPD)患者癥狀嚴(yán)重程度及預(yù)后因素的相關(guān)性,以期探討Th17細(xì)胞水平在判斷COPD臨床預(yù)后方面的可能價(jià)值。方法:選取2013年5月~2014年12月我院就診的110例COPD患者為研究對(duì)象,40例健康體檢者為對(duì)照組。根據(jù)COPD全球倡議(GOLD)將COPD患者分為A組(低危、癥狀輕)、B組(低危、癥狀重)、C組(高危、癥狀輕)及D組(高危、癥狀重),給予吸入性糖皮質(zhì)激素/長(zhǎng)效β_2受體激動(dòng)劑或吸入性糖皮質(zhì)激素/長(zhǎng)效β2受體激動(dòng)劑+長(zhǎng)效膽堿能藥物治療,收集患者治療前及治療3個(gè)月后相關(guān)臨床資料,包括外周血Th17細(xì)胞比例、細(xì)胞因子(IL-17和IL-6)、慢性阻塞性肺疾病評(píng)估測(cè)試(CAT)評(píng)分、年齡、體重指數(shù)、肺功能指標(biāo)及診斷前12個(gè)月COPD急性加重(AECOPD)次數(shù),分析Th17細(xì)胞水平與其它臨床特征間的相關(guān)性。結(jié)果:COPD患者外周血Th17細(xì)胞、IL-17及IL-6水平顯著高于對(duì)照組(P0.05)。隨著COPD癥狀嚴(yán)重程度的增加,B、D組COPD患者外周血Th17細(xì)胞、細(xì)胞因子(IL-17和IL-6)水平及CAT評(píng)分顯著高于A、C組患者(P0.05)。單變量相關(guān)分析發(fā)現(xiàn),治療前B、D組外周血Th17細(xì)胞水平與CAT評(píng)分呈正相關(guān)(P0.05),而與FEV_1、FEV_1% Pred、FVC及FVC% Pred呈負(fù)相關(guān)(P0.05);A、C組外周血Th17細(xì)胞水平與CAT評(píng)分、FEV_1、FEV_1%Pred、FVC及FVC% Pred無(wú)明顯相關(guān)性。治療后外周血Th17細(xì)胞水平與CAT評(píng)分呈正相關(guān)(P0.05),而與FEV_1、FEV_1% Pred、FVC及FVC% Pred呈負(fù)相關(guān)(P0.05)。結(jié)論:外周血Th17細(xì)胞水平與COPD患者IL-17、IL-6、CAT評(píng)分及肺功能指標(biāo)有較好的相關(guān)性,具有評(píng)估COPD患者癥狀嚴(yán)重程度及預(yù)后的潛在臨床價(jià)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.
【作者單位】： 重慶醫(yī)科大學(xué)附屬第一醫(yī)院呼吸內(nèi)科;
【基金】：國(guó)家臨床重點(diǎn)�？茖ｍ�(xiàng)經(jīng)費(fèi)資助課題(No.2012-649)
【分類號(hào)】：R563.9

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