【摘要】：第一章:慢性阻塞性肺疾病中Ig G、Ig A和Ig M型抗支氣管上皮細胞抗體背景:近年來,越來越多的研究表明,自身免疫和支氣管上皮細胞受損在慢性阻塞性肺疾病(COPD)的發(fā)病機制中起重要作用。循環(huán)的抗支氣管上皮細胞抗體(anti-HBEC)結合到COPD患者的支氣管上皮細胞上,可引起支氣管上皮細胞的損傷。因此,本文旨在探討COPD患者血清中Ig A、Ig G和Ig M型anti-HBEC與COPD臨床特點的關系。方法:用間接免疫熒光的方法對170例COPD患者和150例健康對照組血清進行Ig A、Ig G和Ig M型anti-HBEC的檢測,分析該抗體陽性與COPD患者的肺功能、BMI、性別和年齡等的關系。結果:COPD中Ig G型anti-HBEC陽性率明顯高于健康對照組(20.00%vs7.33%,1:100稀釋)(P0.05);Ig A型anti-HBEC陽性率也顯著高于健康對照組(29.41%vs 8.67%,1:40稀釋)(P0.001);Ig M型anti-HBEC陽性率高于對照組,但是無顯著性差異(11.18%vs 6.67%,1:40稀釋)(P0.05)。Ig G和Ig A型anti-HBEC陽性的COPD患者主要集中在GOLD III期和GOLD IV期,并且Ig A型anti-HBEC陽性的COPD患者BMI偏低(P0.05)。結論:Ig G和Ig A型anti-HBEC與COPD的GOLD分期有關聯(lián)。因此本研究表明,Ig G和Ig A型anti-HBEC參與晚期部分COPD的發(fā)病,可能會作為評估COPD嚴重性的新型標志物。第二章:慢性阻塞性肺疾病抗心磷脂抗體水平分析目的:探討抗心磷脂抗體(ACA)與慢性阻塞性肺疾病(COPD)的關系。方法:采用酶聯(lián)免疫吸附試驗(ELISA)的方法檢測了103例COPD患者與72例健康對照者血清中的ACA Ig G/A/M,將COPD組103例分成ACA陽性和陰性兩組,比較ACA陽性和陰性與患者的性別、年齡、體重指數(shù)(BMI)和肺功能指標之間的關系。結果:從定性角度,在COPD組和健康對照組中,ACA的陽性率分別為16.5%(17/103)和4.2%(3/72),兩者之間差異有顯著性的統(tǒng)計學意義(P0.05);在COPD的慢性阻塞性肺疾病全球倡議(GOLD)分期中,從GOLD I到GOLDⅣ期,ACA的陽性率依次為66.7%,18.5%,13.9%,3.2%,逐漸降低。從定量角度,COPD組ACA濃度為4.4±0.7 RU/ml,遠高于健康對照組的2.6±0.4 RU/ml(P0.05);其中,從GOLD I到GOLDⅣ期,ACA濃度依次為10.9±2.6 RU/ml、3.9±1.0 RU/ml、4.8±1.4RU/ml、2.5±0.6 RU/ml。ACA陽性的COPD患者主要集中在GOLD I期,GOLD I期的ACA陽性率和濃度遠高于其它各期。其中,ACA陽性與COPD患者的相關臨床指標沒有明顯的關聯(lián)(P0.05)。結論:ACA與COPD的GOLD分期有關聯(lián),主要出現(xiàn)在疾病早期。因此本研究表明,ACA可能會作為診斷早期COPD的一個新型標志物,并在COPD的發(fā)病機制中起到一定作用。
[Abstract]:Chapter 1: background of Ig G A and Ig M anti bronchial epithelial cell antibodies in chronic obstructive pulmonary disease: in recent years, more and more studies have shown that, Autoimmune and bronchial epithelial cell damage play an important role in the pathogenesis of chronic obstructive pulmonary disease (COPD). Circulating anti-bronchial epithelial cell antibodies (anti-HBEC) bind to the bronchial epithelial cells of COPD patients and can cause the injury of bronchial epithelial cells. Therefore, the purpose of this study was to investigate the relationship between serum Ig Ag G and Ig M anti-HBEC and the clinical characteristics of COPD in patients with COPD. Methods: indirect immunofluorescence was used to detect Ig Ag G and Ig M anti-HBEC in 170 patients with COPD and 150 healthy controls. The relationship between the positive antibody and pulmonary function, BMI, sex and age of COPD patients was analyzed. Results: the positive rate of Ig G type anti-HBEC in COPD was significantly higher than that in the healthy control group (20.00 vs 7.33 vs 1: 100 dilution) (P0.05); Ig A anti-HBEC positive rate was also significantly higher than that in the healthy control group (29.41%vs 8.67 + 1: 40 dilution) (P0.001); Ig M anti-HBEC positive rate was higher than that in the control group). But there was no significant difference (11.18%vs 6.67% dilution) (P0.05). Ig G and Ig A anti-HBEC positive COPD patients were mainly in GOLD III and GOLD IV phase, and Ig A anti-HBEC positive COPD patients BMI was lower (P0.05). Conclusion: Ig G and Ig A anti-HBEC are associated with the GOLD staging of COPD. Therefore, this study suggests that, Ig G and Ig A type anti-HBEC may be a new marker for evaluating the severity of COPD. Chapter 2: analysis of anticardiolipin antibody level in chronic obstructive pulmonary disease objective: to investigate the relationship between anticardiolipin antibody (ACA) and chronic obstructive pulmonary disease (COPD). Methods: the serum ACA Ig G / A / M of 103 patients with COPD and 72 healthy controls were detected by enzyme linked immunosorbent assay (ELISA). The patients in COPD group were divided into two groups: ACA positive group and ACA negative group. The sex and age of ACA positive and negative patients were compared. Relationship between body mass index (BMI) and pulmonary function. Results: qualitatively, the positive rates of ACA in COPD group and healthy control group were 16.5% (17 / 103) and 4.2% (3 / 72), respectively. The difference was statistically significant (P0.05). From GOLD I to GOLD 鈪，

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