下呼吸道细菌定植和稳定期COPD患者免疫状况的关系

摘要

目的：探讨下呼吸道细菌定植和稳定期慢性阻塞性肺疾病(COPD)患者免疫状况的关系。方法选取2010年3月至2013年3月我院收治的稳定期COPD患者50例(病例组)和在我院接受健康体检并确认健康的志愿者50例(健康组)，比较两组受试者的一般资料和免疫细胞水平。根据细菌定植情况将病例组分为定植组和未定植组，比较两组患者的炎性细胞因子水平。结果两组受试者的年龄、性别和体质量指数比较差异均无统计学意义(P>0.05)，而吸烟量、FEV1和FEV1/FVC比较差异均具有统计学意义(P<0.05)。定植组与无定植组痰IL-8、痰IL-6、TNF-α、血IL-8和血hs-CRP水平比较差异均有统计学意义(P<0.05)。健康组和无定植组的辅助T细胞、抑制T细胞、巨噬细胞和中性粒细胞比较差异均无统计学意义(P>0.05)。定植组和无定植组、健康组的辅助T细胞、抑制T细胞、巨噬细胞和中性粒细胞水平比较差异均具有统计学意义(P<0.05)。结论下呼吸道细菌定植可导致稳定期COPD患者免疫功能下降，病情恶化。%Objective To investigate the relationship between lower airway bacterial colonization and the immune status of patients with stable stage of chronic obstructive pulmonary disease (COPD). Methods Fifty pa-tients with stable stage of COPD from March 2010 to March 2013 in our hospital (the study group) and 50 healthy volunteers receiving health examination in our hospital (the healthy group) were enrolled. The general data and the level of immune cells were compared between the two groups. According to the bacterial colonization, pa-tients were divided into colonization group and non-colonization group. The levels of inflammatory factors were compared. Results Age, gender and body mass index showed no statistically significant difference between the two groups (P>0.05), while the amount of smoking, FEV1 and FEV1/FVC had statistically significant difference (P<0.05). Sputum IL-8, sputum IL-6, TNF-α, plasma IL-8 and hs-CRP levels revealed statistically significant difference between the colonization group and the non-colonization group (P<0.05). Helper T cell, suppressor T cell, macrophages and neutrophils had no significant difference between the healthy group and the non-coloniza-tion group (P>0.05), but showed statistically significant difference between colonization group and non-colonization group, healthy group (P<0.05). Conclusion Lower airway bacterial colonization can lead to decreased immune func-tion in patients with stable stage of COPD, thus results in deterioration in disease.