本文選題：COPD + T細(xì)胞��； 參考：《吉林大學(xué)》2012年碩士論文

【摘要】：背景：慢性阻塞性肺疾�。╟hronic obstructive pulmonary diseases，COPD）是一種氣流受限為特征的肺部疾病，氣流受限不完全可逆、呈進(jìn)行性發(fā)展，確切的病因還不十分清楚，但認(rèn)為與肺部對(duì)有害氣體或有害顆粒的異常炎癥反應(yīng)有關(guān)。已發(fā)現(xiàn)的危險(xiǎn)因素包括吸煙、空氣污染、呼吸道感染等外部因素和氣道高反應(yīng)性等內(nèi)部因素。COPD患者經(jīng)常反復(fù)發(fā)病，隨著病情發(fā)展而逐漸加重進(jìn)而產(chǎn)生肺源性心臟病，導(dǎo)致呼吸衰竭及心力衰竭。感染是COPD患者急性發(fā)病的一個(gè)重要原因，免疫功能異常更易引起感染的發(fā)生，近年來(lái)COPD患者淋巴細(xì)胞功能異常受到重視，T淋巴細(xì)胞亞群、B細(xì)胞及NK細(xì)胞水平異常可能在COPD發(fā)生、發(fā)展和預(yù)后起重要作用。但直到今天，COPD患者外周血T淋巴細(xì)胞亞群、B細(xì)胞及NK細(xì)胞的變化并沒(méi)有統(tǒng)一結(jié)論，COPD患者肺功能異常，反復(fù)發(fā)病加重肺功能損傷，通氣和換氣功能障礙導(dǎo)致病人活動(dòng)受限，嚴(yán)重影響正常的生產(chǎn)、生活。 目的：通過(guò)檢測(cè)COPD患者外周血T、B及NK細(xì)胞的變化，探討COPD患者免疫功能紊亂情況，為COPD患者的免疫調(diào)節(jié)治療提供理論支持，并分析T、B、NK細(xì)胞與肺功能FEV1/FVC的關(guān)系。 方法： 選取40例COPD患者，健康對(duì)照組20例。分別比較COPD急性加重期與對(duì)照組、急性加重期與穩(wěn)定期、穩(wěn)定期與對(duì)照組的T細(xì)胞亞群、B細(xì)胞和NK細(xì)胞的差異，并分析急性發(fā)作期T細(xì)胞亞群、B細(xì)胞和NK細(xì)胞與肺功能的關(guān)系。 結(jié)果： 1、COPD急性加重期患者與健康對(duì)照人群比較，，外周血CD3+、CD4+、CD4+/CD8+、NK、B降低，差異有統(tǒng)計(jì)學(xué)意義（P0.05）；CD8+升高，但差異沒(méi)有統(tǒng)計(jì)學(xué)意義（P0.05）； 2、COPD患者穩(wěn)定期與急性加重期相比，CD3+、CD4+、CD4+/CD8+、NK、B升高，但均無(wú)統(tǒng)計(jì)學(xué)意義（P0.05）；CD8+下降，但差異沒(méi)有統(tǒng)計(jì)學(xué)意義； 3、COPD穩(wěn)定期患者與對(duì)照組比較CD3+、CD4+、CD4+/CD8+、NK、B降低，差異有統(tǒng)計(jì)學(xué)意義（P0.05）；CD8+升高，差異無(wú)統(tǒng)計(jì)學(xué)意義（P0.05）； 4、COPD患者急性加重期CD4+T淋巴細(xì)胞、CD4+/CD8+、NK細(xì)胞與肺功能指標(biāo)FEV1/FVC呈正相關(guān)。 結(jié)論： 1、COPD患者存在免疫功能紊亂，細(xì)胞免疫和體液免疫下降，以急性加重期明顯； 2、COPD患者經(jīng)治療達(dá)到穩(wěn)定期后，免疫功能較急性加重期提高，但與健康對(duì)照組相比仍明顯降低，提示穩(wěn)定期免疫功能仍存在紊亂，未完全恢復(fù)正常水平； 3、COPD患者肺功能下降，本試驗(yàn)表明免疫功能降低與肺功能下降有相關(guān)性，這方面有待進(jìn)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.
【學(xué)位授予單位】：吉林大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2012
【分類號(hào)】：R563.9

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