摘要
目的比较慢阻肺患者外周血T淋巴细胞亚群变化,分析引起慢阻肺患者急性加重期(AECOPD)相对危险因素并进行预测评价。方法选取2019年9月至2022年6月收治于我院的98例慢性阻塞性肺疾病(COPD)患者作为研究对象,根据患者病情是否急性加重分为两组,AECOPD组63例(男31例,女32例)和COPD组35例(男18例,女17例);经肺功能参数、血清上清液中炎症生物标志物和外周血中的淋巴细胞水平的检测,单因素以及多因素Logistic回归分析影响COPD患者急性加重的危险因素;构建人工神经网络模型进行预测和模型验证;采用Pearson分析T淋巴细胞亚群与患者肺功能指标的相关性。结果AECOPD组中有吸烟史、SII、NRS2002评分和WBC、NEUT、EOS、CRP、NLR水平显著高于COPD组,FEV_(1)/FVC、FEV_(1)%、PNI、BMI均显著低于COPD组(P均<0.05);AECOPD组的CD3^(+)、CD4^(+)、CD4^(+)/CD8^(+)、Treg水平显著低于COPD组,CD8^(+)、Th17、CD3^(-)CD56^(+)、CD3^(+)CD56^(+)水平高于COPD组(P<0.05);单因素以及多因素结果说明,CD8^(+)、Th17、CD3^(-)CD56^(+)、CD3^(+)CD56^(+)水平增加是引起急性加重的最主要危险因素(OR值均>1,P<0.05);人工神经网络预测模型具有良好的区分度、准确度和有效性;CD8^(+)、NEUT与AECOPD患者FEV_(1)%、FEV_(1)/FVC呈负相关,Th17与患者FEV_(1)%呈负相关,Treg与患者FEV_(1)%、FEV_(1)/FVC呈正相关,CD4^(+)/CD8^(+)与患者FEV_(1)%呈正相关(P<0.05)。结论分析外周血T淋巴细胞亚群变化可以对急性加重的机制有更清楚的了解,对患者的治疗和预后具有十分重要的预测价值,为AECOPD的临床诊断和免疫治疗提供研究思路。
Objective To compare the changes of T lymphocyte subsets in peripheral blood in patients with chronic obstructive pulmonary disease,and to analyze the relative risk factors that cause acute aggravation(AECOPD)in patients with chronic obstructive pulmonary disease,so as to predict and evaluate the risks.Methods 98 patients with chronic obstructive pulmonary disease(COPD)admitted to our hospital from September 2019 to June 2022 were selected as the study subjects.According to whether the patient′s condition was acutely aggravated,they were divided into two groups,63 cases in the AECOPD group(31 male and 32 female)and 35 cases in the COPD group(18 male and 17 female).Through the detection of lung function parameters,inflammatory biomarkers in serum serum and lymphocyte levels in peripheral blood,it used single-factor and multi-factor logistic regression to analyze the risk factors affecting acute aggravation in COPD patients.It constructed an artificial neural network model for prediction and model verification.Pearson was used to analyze the correlation between T lymphocyte subsets and patients′lung function indicators.Results The smoking history,SII,NRS2002 score and WBC,NEUT,EOS,CRP and NLR levels in the AECOPD group were significantly higher than those in the COPD group,and the levels of FEV_(1)/FVC%,FEV_(1)%,PNI and BMI were significantly lower than those in the COPD group(P<0.05).The levels of CD3^(+),CD4^(+),CD4^(+)/CD8^(+)and Treg in the AECOPD group were significantly lower than that in the COPD group,and the levels of CD8^(+),Th17,CD3^(-)CD56^(+)and CD3^(+)were higher than those in the COPD group(P<0.05).Single-factor and multi-factor results showed that the increase in levels of CD8^(+),Th17,CD3^(-)CD56^(+)and CD3^(+)CD56^(+)was the most important risk factor causing acute aggravation(OR>1,P<0.05).The artificial neural network prediction model had good distinction and accuracy.CD8^(+)and NEUT were negatively correlated with FEV_(1),FEV_(1)/FVC in AECOPD patients,Th17 was negatively correlated with FEV
作者
唐文君
曾珠
孙增涛
杨洪静
杨帆
TANG Wenjun;ZENG Zhu;SUN Zengtao;YANG Hongjing;YANG Fan(Department of Respiratory Medicine,Affiliated Hospital of Chengdu University of Traditional Chinese Medicine,Chengdu,Sichuan 610072,China;Department of Respiratory and Critical Care Medicine,the First Affiliated Hospital of Chengdu Medical College,Chengdu,Sichuan 610500,China)
出处
《临床肺科杂志》
2023年第10期1511-1518,共8页
Journal of Clinical Pulmonary Medicine
基金
四川省科学技术厅项目(No.2022YFS0423)
成都市科学技术局项目(No.2021-YF05-02035-SN)。
关键词
外周血T淋巴细胞亚群
慢阻肺
急性加重
肺功能
预测
peripheral blood T lymphocyte subset
chronic obstructive pulmonary
acute aggravation
lung function
prediction
