不同分期老年COPD患者外周血中CD4+ Foxp3+调节性T细胞变化及其与肺功能改变的相关性

摘要

目的 观察急性期、稳定期老年慢性阻塞性肺病(CoPD)患者和健康人外周血中的CD4+ Foxp3+调节性T细胞(Treg细胞)比例变化,分析Treg细胞与各期老年COPD患者肺功能改变的相关性,探讨Treg细胞在老年COPD发生发展中的作用.方法 ①随机选取2010年2-12月就诊我院呼吸内科的急性期老年COPD患者30例、稳定期老年COPD患者35例,分别设为实验1组和实验2组,选取同期进行社区流行病学调查的健康人25例设为对照组.所有受试者均填写统一的调查问卷,了解他们的一般情况、吸烟史等99个变量,并完善肺功能检查；②各组受试者空腹6h后于清晨8时肘正中静脉抽取静脉血2ml,应用细胞内染色的流式细胞术检测各组受试者外周血中Treg细胞；③多组间比较采用单因素方差分析,多组内两两比较采用SNK检验(方差齐)和Games-Howell法(方差不齐),Treg细胞的比例与肺功能关系用Spearman相关分析进行相关性检验.结果 ①实验1组、实验2组和对照组外周血Treg细胞比例分别为(2.62±0.68)％、(0.86±0.46)％和(1.45±0.70)％,三组结果两两比较差异显著(P＜0.05)；②实验1组、实验2组和对照组外周血CD4和CD25双阳性细胞比例为(3.90±1.64)％、(3.01±1.40)％和(3.78±1.83)％,三组比较无统计学意义(P＞0.05)；③外周血Treg细胞比例与第1秒用力呼气容积实测值与预计值比(FEV1％ prep)和第1秒用力呼气容积/用力肺活量比(FEV1/FVC)均无相关性(r=-0.158、-0.188,P值分别为0.136、0.076)；外周血Treg细胞比例与年龄之间无相关性(r值为0.014,P＞0.05).结论 老年COPD患者体内存在免疫功能失调,Treg细胞可能参与了老年COPD的发病和急性加重过程;外周血中的CD4+ Foxp3+ Treg细胞的比例与老年COPD患者肺功能无相关性.%Objective To observe the changes in proportion of CD+4 Foxp+3 regulatory T cells(Treg cells) in peripheral blood of a-cute stage and stable senile COPD patients ,to analyze the correlation between Treg cells and pulmonary function of senile COPD patients. To investigate the role of Treg cells played at the onset of senile COPD. Methods 30 patients with acute stage senile COPD and 35 patients with stable senile COPD were investigated as groupl and group 2,they came from respiratory medicine of our hospital between February ,2010 and December,2010. Another 25 healthy volunteers from epidemiology study were investigated as control group. All the participants filled out the unified questionnaire, recording about 99 variables including their general condition, smoking history etc and checking their pulmonary function. Every group's blood samples was collected at 8 o'clock in the morning after 6 hours of fasting. The proportion of Treg cells in peripheral blood was measured by flow cytometry method. Results The proportions of groupl, group2 and control group were [ (2. 62 ± 0. 68 )%),[(0. 86 ± 0. 46) % ] and [ ( 1.45 ± 0. 70) % ], there was significant difference between multiple pairwise comparisons ( P < 0. 05) ; The CD4 and CD25 double positive cell rate in peripheral blood of groupl, group2 and control group were [ (3. 90 ± 1. 64)% ] , [ (3. 01 ±1.40)%] and ((3. 78 ±1. 83)%], there was no difference among the 3 groups. The proportion of Treg cells in peripheral blood and FEV1% prep and FEV1/FVC% was not correlated(r= -0. 158, -0. 188 and P =0. 136,0. 076);there was not correlated between the proportion of Treg cells and age(r =0.014, P>0.05). Conclusions Immune disorders may exist in COPD patients, and Treg cells may be involved in the process of the pathogenesis of senile COPD and acute exacerbation. There are no correlation between the proportion of Treg cells in peripheral blood and pulmonary function.