【摘要】：目的： 研究可溶性程序性死亡因子-l(sPD-1)在老年慢性阻塞性肺疾病（COPD）患者及老年慢性阻塞性肺疾病急性加重期（AECOPD）患者外周血的表達(dá)。初步探討其是否參與了COPD的發(fā)病機(jī)制。 方法： 選擇老年COPD患者(31例)為研究對(duì)象。其中穩(wěn)定期COPD患者(COPD組)10例，老年COPD急性加重期患者(AECOPD組)31例（包括COPD穩(wěn)定期隨訪的10名患者急性加重期）。20例老年健康人為正常對(duì)照組。分別用ELISA試劑盒檢測(cè)外周血中sPD-1的表達(dá)情況。統(tǒng)計(jì)結(jié)果采用SPSS13.0進(jìn)行分析。 結(jié)果： 老年COPD及AECOPD患者、健康老年人血清中均存在適量sPD-1的表達(dá)。血清中sPD-1在老年COPD者含量為（51.11±9.90ng/ml）；而老年AECOPD患者為（51.70±9.33ng/ml），均低于健康生理?xiàng)l件下表達(dá)水平(92.53±12.00ng/ml)，兩者與正常對(duì)照組相比均有顯著性差異（P＜0.05）。對(duì)隨訪的10名老年COPD患者檢測(cè)其穩(wěn)定期和急性加重期血清中sPD-1含量進(jìn)行比較，兩者間差異無統(tǒng)計(jì)學(xué)意義（P＝0.70）。 結(jié)論： 本研究觀察了sPD-1在健康老年人、老年患者COPD穩(wěn)定期及急性加重期血清中的表達(dá)，結(jié)果顯示與正常對(duì)照組相比，AECOPD組、COPD組外周血中sPD-1表達(dá)均明顯降低(P0．05)。提示老年COPD患者體內(nèi)存在sPD-1的表達(dá)下調(diào)，可能導(dǎo)致體內(nèi)正負(fù)性刺激信號(hào)失去了平衡的相互作用，致使體內(nèi)負(fù)性共刺激信號(hào)增多，使細(xì)胞免疫處于被抑制狀態(tài)。導(dǎo)致慢性炎性反應(yīng)。因此，，我們推測(cè)sPD-1應(yīng)該有參與COPD的細(xì)胞免疫應(yīng)答反應(yīng)。然而，對(duì)隨訪COPD患者穩(wěn)定期與急性加重期外周血sPD-1水平無統(tǒng)計(jì)學(xué)差異，可能與納入研究數(shù)目不足有關(guān)，有待進(jìn)一步研究。
[Abstract]:Aim: to investigate the expression of soluble programmed death factor-1 (sPD-1) in peripheral blood of elderly patients with chronic obstructive pulmonary disease (COPD) and aged patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD). To explore whether it is involved in the pathogenesis of COPD. Methods: 31 elderly patients with COPD were selected. There were 10 patients with stable COPD (COPD group), 31 elderly patients with acute exacerbation of COPD (AECOPD group) (including 10 patients with acute exacerbation of COPD) and 20 healthy people as normal control group. The expression of sPD-1 in peripheral blood was detected by ELISA kit. The statistical results were analyzed by SPSS13.0. Results: in elderly patients with COPD and AECOPD, and in healthy elderly patients, there was a moderate expression of sPD-1 in serum. The content of sPD-1 in serum in elderly patients with COPD was (51.11 鹵9.90ng/ml). The expression level of AECOPD in elderly patients was (51.70 鹵9.33ng/ml), lower than that in healthy subjects (92.53 鹵12.00ng/ml), and there was a significant difference between the two groups (P < 0. 05). The levels of serum sPD-1 in 10 elderly patients with COPD in stable and acute exacerbations were compared. There was no significant difference between the two groups (P0. 70). Conclusion: in this study, we observed the expression of sPD-1 in the serum of healthy elderly and elderly patients during the stable and acute exacerbation of COPD. The results showed that compared with the normal control group, the expression of sPD-1 in the AECOPD group was higher than that in the normal control group. The expression of sPD-1 in peripheral blood of COPD group was significantly decreased (P0.05). It is suggested that the down-regulation of sPD-1 expression in elderly patients with COPD may lead to the imbalance of positive and negative stimuli, increase the number of negative co-stimuli in vivo and inhibit cellular immunity. Causes chronic inflammatory reactions. Therefore, we speculate that sPD-1 should be involved in the cellular immune response to COPD. However, there was no significant difference in the level of peripheral blood sPD-1 between stable and acute exacerbations of COPD patients, which may be related to the insufficient number of inclusive studies, and need further study.
【學(xué)位授予單位】：華中科技大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2013
【分類號(hào)】：R563.9

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