CAJ | 학술논문

目的：观察稳定期COPD患者和健康人吸烟和非吸烟者外周血中的T辅助细胞( Th细胞)17和调节性 T 细胞( Treg 细胞)比例差异,分析吸烟对稳定期 COPD 患者 Th17/Treg的影响,探讨吸烟引发COPD发生发展的可能免疫机制。方法①选取2012年12~2013年4月我院就诊的稳定期COPD 患者73例,分别设为不吸烟组46例、吸烟组27例,同时选取同期进行社区流行病学调查及医院体检中心的健康人26例设为对照组,不吸烟组16例和吸烟组10例。所有受试者均填写统一的调查问卷,明确个人史,现病史、用药史,完善肺功能检查；②各组受试者空腹6 h后清晨抽取静脉血2 ml,应用细胞内染色的流式细胞术检测各组受试者外周血中 Th17/Treg 细胞比例；③多组间比较采用单因素方差分析,多组内两两比较采用SNK 检验(方差齐)和 Games-Howell 法(方差不齐), Th17/Treg 细胞的比例与吸烟指数及肺功能关系用Spearman相关分析进行相关性检验。结果① COPD组吸烟者和非吸烟者与对照组吸烟与非吸烟者外周血Th17/Treg细胞比例分别为(3．23±0．86)%、(2．97±0．98)%和(2．07±0．40)%、(1．96±0．30)%,多组间比较差异呈显著性(P<0．01)；② COPD患者吸烟组和非吸烟组第1秒用力呼气容积实测值与预计值比(FEV1% prep)分别为(55．66±20．61)%、(64．04±13．80)%,第1秒用力呼气容积/用力肺活量比(FEV1/FVC)分别为(55．23±10．52)%、(62．62±5．49)%,两组间差异存在统计学意义(P<0．05)；③外周血Th17/Treg细胞比例与FEV1% prep和FEV1/ FVC存在显著相关性(r=-0．517、-0．512,P值分别为0．00,0．00)。结论吸烟与COPD患者Th17/Treg细胞比例失衡相关； Th17/Treg细胞比例失衡可能参与了发病和进展过程；吸烟可能通过引起Th17/Treg细胞比例失衡导致COPD的发生发展。
목적：관찰은정기COPD환자화건강인흡연화비흡연자외주혈중적T보조세포( Th세포)17화조절성 T 세포( Treg 세포)비례차이,분석흡연대은정기 COPD 환자 Th17/Treg적영향,탐토흡연인발COPD발생발전적가능면역궤제。방법①선취2012년12~2013년4월아원취진적은정기COPD 환자73례,분별설위불흡연조46례、흡연조27례,동시선취동기진행사구류행병학조사급의원체검중심적건강인26례설위대조조,불흡연조16례화흡연조10례。소유수시자균전사통일적조사문권,명학개인사,현병사、용약사,완선폐공능검사；②각조수시자공복6 h후청신추취정맥혈2 ml,응용세포내염색적류식세포술검측각조수시자외주혈중 Th17/Treg 세포비례；③다조간비교채용단인소방차분석,다조내량량비교채용SNK 검험(방차제)화 Games-Howell 법(방차불제), Th17/Treg 세포적비례여흡연지수급폐공능관계용Spearman상관분석진행상관성검험。결과① COPD조흡연자화비흡연자여대조조흡연여비흡연자외주혈Th17/Treg세포비례분별위(3．23±0．86)%、(2．97±0．98)%화(2．07±0．40)%、(1．96±0．30)%,다조간비교차이정현저성(P<0．01)；② COPD환자흡연조화비흡연조제1초용력호기용적실측치여예계치비(FEV1% prep)분별위(55．66±20．61)%、(64．04±13．80)%,제1초용력호기용적/용력폐활량비(FEV1/FVC)분별위(55．23±10．52)%、(62．62±5．49)%,량조간차이존재통계학의의(P<0．05)；③외주혈Th17/Treg세포비례여FEV1% prep화FEV1/ FVC존재현저상관성(r=-0．517、-0．512,P치분별위0．00,0．00)。결론흡연여COPD환자Th17/Treg세포비례실형상관； Th17/Treg세포비례실형가능삼여료발병화진전과정；흡연가능통과인기Th17/Treg세포비례실형도치COPD적발생발전。
Objective To observe and compare the changes in proportion of T help cells 17 (Th17) to regu-latory T cells ( Treg cells) in peripheral blood among stable COPD patients, smokers and non-smokers. Methods 73 COPD patients at stable stage were divided into the group A ( non-smoker) and the group B ( smoker) by their smoking history. Another 26 healthy volunteers from epidemiology study and medical examination center were taken as the control group, which included 16 smokers and 10 non-smokers. All the participants filled out the unified ques-tionnaire, recording about their general condition, smoking history, past medical history and pulmonary function. Ev-ery group's blood sample was collected in the morning 6 hours after empty stomach. The proportion of Th17/Treg in peripheral blood was measured by flow cytometry method. Results The proportions were (3. 23 ± 0. 86), (2. 97 ± 0. 98), (2. 07 ± 0. 40), (1. 96 ± 0. 30) respectively in the groups A and B and the control group (P<0. 05). The FEV1% prep and FEV1/FVC% in the group A and the group B were (55. 66 ± 20. 61)%, (64. 04 ± 13. 80)% and (55. 23 ± 10. 52)%, (62. 62 ± 5. 49)%. The proportion of Th17/Treg in peripheral blood and FEV1% prep and FEV1/FVC% was correlated (r= -0. 517, -0. 512 and P=0. 00). Conclusion Immune disorders may exist in COPD patients and smokers, and the proportion of Th17/Treg may be involved in the onset and process of the patho-genesis of COPD.