COPD患者T淋巴细胞亚群比例及其与BODE指数和急性加重风险的相关性

摘要

目的:探讨慢性阻塞性肺疾病(COPD)患者外周血T淋巴细胞亚群的比例,判定其与BODE指数及急性加重风险的相关性.方法:分别选择69例COPD患者(吸烟者44例,非吸烟者25例)和50例健康志愿者,采用流式细胞仪检测两组受试者外周血T淋巴细胞亚群;分析COPD患者的BODE指数及1年随访期内COPD患者急性加重住院治疗次数与T淋巴细胞亚群的相关关系.结果:COPD组外周血CD3+、CD4+T淋巴细胞和CD4+/CD8+比例均低于健康志愿组(P<0.01),而CD8+T淋巴细胞无明显改变(P>0.05);COPD吸烟者外周血CD4+T淋巴细胞和CD4+/CD8+比例明显低于COPD非吸烟者(P<0.01),CD3+、CD8+T淋巴细胞与COPD非吸烟者相比无差异性(P>0.05).CD4+T淋巴细胞和CD4+/CD8+比例与BODE指数显著负相关(r=-0.440、P=0.000;r=-0.456、P=0.000),而CD3+、CD8+T淋巴细胞与BODE指数无明显相关性(r=-0.200、P=0.099;r=-0.207、P=0.088);CD3+、CD4+T淋巴细胞和CD4+/CD8+水平与COPD急性加重次数呈明显负相关(r=-0.264、P=0.028;r=-0.296、P=0.013;r=-0.245、P=0.042),而CD8+T淋巴细胞与COPD急性加重次数无明显相关性(r=-0.005、P=0.967).结论:CD4+T淋巴细胞和CD4+/CD8+水平可能与COPD的严重程度和COPD急性加重密切相关,且吸烟影响COPD患者外周T淋巴细胞亚群的比例.%Objective:To investigate the proportion of peripheral blood T-lymphocyte subsets and body mass index,airflow obstruction,dyspnea,and exercise capacity index(BODE index) in predicting the acute exacerbation risks in patients with chronic obstructive pulmonary disease(COPD).Methods: Sixty-nine COPD patients(44 cigarette smokers and 25 non-smokers) and 50 healthy volunteers were enrolled,and underwent measurement of peripheral blood T-lymphocyte subsets with flow cytometry.BODE index were measured in COPD patients for assessing the relation of the number of hospitalization due to acute exacerbation with the levels of T-lymphocyte subsets in one-year follow-up period.Results:COPD patients had lower peripheral blood ratio of CD3+,CD4+ T-lymphocyte and CD4+/CD8+ than healthy volunteers(P<0.01),yet CD8+ T-lymphocytes had no obvious change(P>0.05).The ratio of CD4+ T-lymphocyte and CD4+/CD8+ in peripheral blood in smokers was lower than that of non-smokers(P<0.01),whereas CD3+ and CD8+ T-lymphocyte had no significant difference with non-smokers(P>0.05).CD4+T-lymphocyte and CD4+/CD8+ ratio were negatively correlated with BODE index(r=-0.440,P=0.000;r=-0.456,P=0.000,respectively),yet CD3+ and CD8+T-lymphocytes had no significant relation with BODE index(r=-0.200,P=0.099;r=-0.264,P=0.028;r=-0.296,P =0.088,respectively).CD3+,CD4+T-lymphocyte and CD4+/CD8+ levels were negatively correlated with the hospitalization frequencies due to acute exacerbations(r=-0.264,P=0.028;r=-0.296,P=0.013;r=-0.245,P=0.042,respectively),and CD8+T-lymphocytes had no obvious relation with the number of COPD exacerbations(r=-0.005,P=0.967).Conclusion:CD4+ and CD4+/CD8+ T-lymphocyte levels are important roles in the pathogenesis of COPD,indicating that these lymphocytes may be closely correlated with severity and acute exacerbation of COPD,and cigarette smoking could affect the proportion of peripheral blood T-lymphocyte subsets in patients with COPD.