摘要
目的观察慢性阻塞性肺疾病(COPD)合并肺结核(PTB)患者免疫功能、凝血功能与肺功能相关因子的水平变化,并分析其临床意义。方法选取2018年2月—2020年2月本院收治的84例COPD合并PTB(合并组)及同期收治的77例COPD(COPD组)、62例PTB(PTB组)作为研究对象;另选取同期体检的60名健康人作为对照组。检测各组免疫功能指标(外周血CD4^(+)、CD8^(+)、CD4^(+)/CD8^(+),血清IgA、IgG、IgM)、凝血功能指标(血清IFN-γ和sIL-2R,血浆D-D、FIB)和肺功能指标[第1s用力呼气量(FEV1)、第1s用力呼气量/用力肺活量(FEV1/FVC)];对结果进行描述分析。结果合并组、COPD组及PTB组免疫功能指标CD4^(+)、CD4^(+)/CD8^(+)均低于对照组,CD8^(+)均高于对照组;合并组、PTB组血清IgA、IgG均高于对照组;COPD组CD4^(+)、IgA、IgG均低于合并组与PTB组;合并组CD4^(+)/CD8^(+)均低于PTB组;合并组、COPD组及PTB组凝血功能指标IFN-γ、sIL-2R、D-D、FIB均高于对照组,肺功能指标FEV1、FEV1/FVC水平均低于对照组;PTB组凝血功能指标IFN-γ、sIL-2R低于COPD组、合并组,COPD组血浆D-D、FIB低于合并组,FEV1、FEV1/FVC高于合并组;合并组IFN-γ、sIL-2R、D-D、FIB高于PTB组,FEV1、FEV1/FVC低于PTB组;上述差异均有统计学意义(P值均<0.05)。CD4^(+)、CD4^(+)/CD8^(+)与FEV1、FEV1/FVC均呈正相关(P值均<0.05),CD8^(+)、IgA、IgG、IFN-γ、sIL-2R、D-D、FIB与FEV1、FEV01/FVC均呈负相关(P值均<0.05),IgM与FEV1、FEV1/FVC无相关(P值均>0.05)。结论COPD、PTB及COPD合并PTB患者中均存在免疫功能、凝血功能和肺功能异常,COPD合并PTB患者免疫功能、凝血功能紊乱程度更严重,临床上应制定针对性的有效治疗方案。
Objective To observe the changes of immune function,coagulation function and pulmonary function related factors in patients with chronic obstructive pulmonary disease(COPD)and pulmonary tuberculosis(PTB);to analyze the clinical significance.Methods A total of 84 cases of COPD combined with PTB(combined group)and 77 cases of COPD(COPD group)and 62 cases of PTB(PTB group)admitted to our hospital from Feb 2018 to Feb 2020 were selected as study objects,and 60 healthy people taking physical examination in the same period were selected as control group.The immune function indexes(peripheral blood CD4^(+),CD8^(+),CD4^(+)/CD8^(+);serum IgA,IgG,IgM),coagulation function indexes(serum IFN-γand sIL-2 R,plasma D-D,FIB)and lung function indexes[first second forced expiratory volume(FEV1),first second forced expiratory volume/forced vital capacity(FEV1/FVC)]were detected;all above results were described and analyzed.Results CD4^(+),CD4^(+)/CD8^(+)levels in the combined group,COPD group and PTB group were significantly lower than those in the control group,and CD8^(+)levels were significantly higher than those in the control group;IgA and IgG levels of the combined group,PTB group were significantly higher than those of the control group;CD4^(+),IgA and IgG in COPD group were significantly lower than those in combination group and PTB group;CD4^(+)/CD8^(+)in the combined group was significantly lower than that in the PTB group;IFN-γ,sIL-2 R,D-D and FIB in the combined group,COPD group and PTB group were significantly higher than in the control group;while the FEV1 and FEV1/FVC were significantly lower than those in the control group;in PTB group,IFN-γand sIL-2 Rwere significantly lower than those in COPD group and combined group;D-D and FIB in COPD group were significantly lower than those in combined group,and FEV1 and FEV1/FVC were significantly higher than those in combined group;IFN-γ,sIL-2 R,D-D and FIB in the combined group were significantly higher than those in the PTB group,and FEV1 and FEV1/FVC were significantly
作者
曹瑛
马天丽
李俊
梁瑞霞
CAO Ying;MA Tian-li;LI Jun;LIANG Rui-xia(Department of tuberculosis,the Fifth People's Hospital of Xinyang City,Henan Xinyang 464000,China;不详)
出处
《江苏预防医学》
CAS
2021年第2期163-166,共4页
Jiangsu Journal of Preventive Medicine
基金
河南省医学科技攻关计划项目(LHGI201906229)。
关键词
慢性阻塞性肺疾病
肺结核
细胞免疫
体液免疫
炎症反应
凝血功能
Chronic obstructive pulmonary disease
Pulmonary tuberculosis
Cellular immunity
Humoral immunity
Inflammatory response
Coagulation function
