摘要
目的探讨辅助性T细胞17(Th17)、调节性T细胞(Treg)、Th17/Treg、白细胞介素-17(IL-17)在慢性阻塞性肺疾病(COPD)患者中的表达及与肺功能的相关性。方法选取184例COPD患者[COPD稳定期及COPD急性加重期(AECOPD)各92例]作为COPD组,另选同期健康体检者95例作对照组。采用流式细胞仪技术测定所有受检者外周血中Th17细胞、Treg细胞及Th17/Treg比值,ELISA法测定血清IL-17水平,比较各组Th17、Treg、Th17/Treg、IL-17及肺功能指标的变化。Spearman相关分析Th17、Treg、Th17/Treg、IL-17与肺功能指标的相关性,并绘制受试者工作特征(ROC)曲线评价Th17、Treg、Th17/Treg及IL-17对AECOPD患者的诊断效能。结果与对照组比较,COPD稳定期组及AECOPD组外周血Th17、Th17/Treg及IL-17水平均明显升高(P均<0.05),且AECOPD组升高更明显(P均<0.05)。与对照组比较,COPD稳定期组及AECOPD组外周血Treg细胞含量及FEV_1、FEV_1%、FVC%、FEV_1/FVC均明显下降(P均<0.05),且AECOPD组下降更明显(P均<0.05)。相关性分析显示,COPD患者外周血Th17、Th17/Treg及IL-17与FEV_1、FEV_1%、FVC、FVC%、FEV_1/FVC均呈负相关(P均<0.05);而COPD患者外周血Treg细胞与FEV_1、FEV_1%、FVC、FVC%、FEV_1/FVC均呈正相关(P均<0.05)。ROC曲线显示,外周血Th17、Treg、Th17/Treg及IL-17诊断AECOPD的曲线下面积(AUC)及95%CI分别为0.862[0.764,0.963],0.783[0.705,0.848],0.814[0.726,0.875],0.851[0.758,0.946],Th17最佳临界值为7.28%时其诊断AECOPD的灵敏度和特异度最好,分别为80.4%和87.3%。结论外周血Th17、Treg、Th17/Treg及IL-17与COPD患者肺功能指标有良好的相关性,是早期预测AECOPD的有效指标。
Objective It is to investigate the expression of T helper cells 17（ Th17）,T regulatory cell（ Treg）,Th17/Treg,interleukin-17（ IL-17） in patients with chronic obstructive pulmonary disease（ COPD） and its correlation with lung function. Methods 184 patients with COPD [COPD stable phase group（ n = 92） and COPD acute exacerbation（ AECOPD） group（ n = 92）] were selected as COPD group,and 95 health examiners at the same period were selected as control group. Th17 cells,Treg cells and Th17/Treg ratios in peripheral blood were measured by flow cytometry,and serum IL-17 level was measured by ELISA. The changes of Th17,Treg,Th17/Treg,IL-17 and pulmonary function indicators in each group were compared. Spearman correlation analysis was used to analyze the correlation of Th17,Treg,Th17/Treg,IL-17 with lung function index,and the receiver operating characteristic（ ROC） curve was drew to evaluate the diagnosis value of Th17,Treg,Th17/Treg and IL-17 for the patients with AECOPD. Results The levels of Th17,Th17/Treg and IL-17 in peripheral blood of COPD group and AECOPD group were significantly higher than those in control group（ P〈0.05）,and the increase of these indexes in AECOPD group were more significant（ P〈0.05）. The content of Treg cells in peripheral blood and FEV1,FEV1%,FVC%,FEV1/FVC in COPD group and AECOPD group were significantly lower than those in control group（ P〈0.05）,and the decrease of these indexes in AECOPD group were more significant（ P〈0.05）. Correlation analysis showed that Th17,Th17/Treg,IL-17 in peripheral blood wre negatively correlated with FEV1,FEV1%,FVC,FVC% and FEV1/FVC in COPD patients（ P〈0.05）,while Treg in peripheral blood cells was positively correlated with FEV1,FEV1%,FVC,FVC% and FEV1/FVC（ P〈0.05）. The ROC curve showed that the area under the curve（ AUC）and 95% CI of peripheral blood Th17,Treg,Th17/Treg and IL-17 in the diagnosis of AECOPD were 0. 862（ 0. 764-0. 963）,0. 783（0. 705-0. 848）,0. 814（0. 726-0. 875）,0.
作者
张占强
吴春艳
方彬
王美玲
牛慧艳
ZHANG Zhanqiang1 , WU Chunyan2 , FANG Bin , WANG Meiling , NIU Huiyan1(1. The Hospital of Zhuozhou City, Zhuozhou 072750, Hebei, China;2. The First Central Hospital of Baoding, Baoding 071000, Hebei, China)
出处
《现代中西医结合杂志》
CAS
2018年第22期2419-2423,2494,共6页
Modern Journal of Integrated Traditional Chinese and Western Medicine
基金
保定市科学计划与发展指导计划项目(15ZF058)
