慢性阻塞性肺疾病住院患者诱导痰细胞计数与肺功能的相关性

摘要

目的：探讨住院慢性阻塞性肺疾病（ COPD）患者诱导痰液细胞计数与肺功能的相关性。方法正常对照组6例，COPD组18例，各组行诱导痰和肺功能及炎症指标的检查。肺功能指标包括：第1秒呼气容积占预计值％（ FEV1％pre）、第1秒呼气容积占用力肺活量比值（ FEV1/FVC）及用力呼气中段流速（ FEF25％～75％）；炎症指标包括：超敏C反应蛋白（hs-CRP）、降钙素原（PCT）。分析住院慢性阻塞性肺疾病（COPD）患者诱导痰细胞计数与肺功能的相关性。结果（1）与正常对照组比较，COPD住院患者诱导痰中性粒细胞比例[（20．65±6．32）％ vs （58．39±6．76）％，P＝0．005）、嗜酸性粒细胞比例明显增高[（1．50±0．57）％ vs （7．00±2．30）％，P＝0．002）；与COPD组比较，正常对照组诱导痰中巨噬细胞明显升高（ P＝0．031），正常对照组诱导痰中以巨噬细胞为主。（2）与正常对照组比较，COPD住院患者中hs-CRP[（1．90±0．54） mg/L vs （4．28±0．91） mg/L，P＝0．018）及PCT [（0．05±0．035）μg/mL vs （0．14±0．025）μg/mL，P＝0．020]均增高。（3）COPD住院患者诱导痰中性粒细胞与FEV1％pre呈负相关（r＝-0．481，P＜0．05），与FEV1/FVC亦呈负相关（r＝-0．583，P＜0．05）。结论 COPD住院患者诱导痰中性粒细胞计数与肺功能减退有相关性，提示中性粒细胞在COPD的发病机制中具有重要作用。%Objective To investigate the relation between induced sputum cell counts and lung function in patients hospi -talized for chronic obstructive pulmonary disease .Methods We divided the all subjects into two groups , including 6 cases of normal control group and 18 cases of COPD patient group .Both groups were examined for sputum cell count , lung func-tion and inflammatory markers .Lung function indicators included total expiratory volume in one second percentage of pre -dicted value ( FEV1%pre) , expiratory volume in one second vital capacity ratio of occupied ( FEV1/FVC) and forced mid-expiratory flow ( FEF25%-75%);inflammatory markers included high sensitivity C -reactive protein ( hs-CRP) and procal-citonin (PCT).The association of cell counts of induced sputum with lung function in COPD patients was analyzed using SPSS17.0 statistical software.Results 1) Induced sputum neutrophils and percentage of eosinophils in hospitalized COPD patients increased significantly compared to healthy individuals (P=0.005 and P=0.002, repectively).Macrophages in healthy people were higher than COPD patients (P=0.031).Macrophages were mainly in induced sputum of healthy peo-ple;2) hs-CRP and PCT in hospitalized COPD patients were higher than healthy individuals (P=0.018 and P=0.020, respectively);3) Induced sputum neutrophils of hospitalized COPD patients were negatively correlated to FEV 1%pre (r=-0.481, P<0.05), and FEV1/FVC (r=-0.583, P<0.05).Conclusion Neutrophil counts of induced sputum in hospitalized COPD patients correlates with lung function , suggesting important roles of neutrophils in the pathogenesis of COPD.