慢性阻塞性肺疾病合并肺结核患者部分细胞因子水平的表达及其意义

doi:10.3969/j.issn.1000-6621.2014.03.010

摘要/Abstract

摘要： 目的探讨慢性阻塞性肺疾病（chronic obstructive pulmonary disease，COPD）合并肺结核患者部分细胞因子水平的表达及其意义。方法对2012年7月至2013年6月间住院诊治的50例COPD合并肺结核患者（研究组）、50例肺结核患者（肺结核对照组）、50例COPD患者（COPD对照组），以及50名健康志愿者（健康对照组）的细胞免疫功能进行检测。采用流式细胞仪抗体双标法检测各组人员的外周血自然杀伤细胞（natural killer cell，NK细胞）、T淋巴细胞亚群（CD4⁺、CD8⁺、CD4⁺/CD8⁺）的表达率，采用ELISA法测定患者血清中白细胞介素（IL）-1、可溶性白细胞介素-2受体（sIL-2R）、IL-6、γ干扰素（IFN-γ）及肿瘤坏死因子α（TNF-α）的表达水平。多组间比较采用单因素方差分析，两组间比较采用t检验。结果 COPD对照组的NK细胞比率［（15.34±8.11）%］高于研究组［（12.37±6.96）%］和肺结核对照组［（12.53±7.14）%］（t值分别为2.20和2.08，P值均＜0.05），研究组CD4⁺ T淋巴细胞比率［（30.09±11.09）%］低于肺结核对照组［（39.80±9.42）%］（t=2.80，P<0.01）。研究组的IL-1表达水平［（30.14±20.84）ng/L］高于COPD对照组［（23.54±9.94）ng/L］（t=2.00，P<0.05）；COPD对照组的sIL-2R的表达水平［（114.70±49.32）pmol/L］低于研究组［（168.78±94.92）pmol/L］与肺结核对照组［（182.68±74.91）pmol/L］（t=4.07和5.12，P值均＜0.01）；在IL-6的表达上，肺结核对照组［（75.62±75.97）ng/L］高于研究组［（51.46±35.86）ng/L］与COPD对照组［（48.90±30.04）ng/L］（t值分别为2.68和2.97，P值均＜0.01）；研究组［（28.82±32.40）ng/L］与肺结核对照组［（29.90±23.79）ng/L］的IFN-γ表达均高于COPD对照组［（16.60±9.27）ng/L］（t值分别为2.89和3.15，P值均＜0.01）。结论与对照组相比，研究组患者存在以NK细胞、CD4+ T淋巴细胞为主的细胞免疫功能低下，同时还存在IL-1、sIL-2R、IL-6、IFN-γ等细胞因子表达异常。

关键词: 结核, 肺/并发症, 肺疾病, 慢性阻塞性, 细胞因子类

Abstract: Objective To explore the changes and the significance of cellular immune function in patients with chronic obstructive pulmonary disease (COPD) complicated by pulmonary tuberculosis (TB). Methods Fifty in-patients with COPD complicated with pulmonary TB who were detected during July 2012 to June 2013 were enrolled in the study as a study group; the other 50 pulmonary TB patients, 50 COPD patients and 50 healthy people were also enrolled as the control groups. The percentages of NK cells (natural killer cell) and T lymphocyte subsets (such as CD4⁺, CD8⁺ and CD4⁺/CD8⁺) in peripheral blood were measured by flow cytometry-based antibody double-labeling method in all enrolled subjects; the levels of IL-1, sIL-2R, IL-6, IFN-γ and TNF-ɑ were also mea-sured using ELISA method. Single-factor analysis of variance was used for comparison among groups, and t test was used for comparison between two groups. Results The percentage of NK cell in the control group with COPD patients (15.34±8.11)% was higher than that in the control group with TB patients (12.53±7.14)% and the study group (12.37±6.96)% (t=2.08 and 2.20, respectively, both P<0.05). The percentage of CD4⁺ T lymphocyte in the control group with TB patients (39.80±9.42)% was higher than that in the study group (30.09±11.09)% (t=2.80, P<0.01). The level of IL-1 in the study group (30.14±20.84) ng/L was higher than that in the control group with COPD patients (23.54±9.94) ng/L (t=2.00, P<0.05). The level of sIL-2R in the control group with COPD patients (114.70±49.32) pmol/L was lower than that in the study group (168.78±94.92) pmol/L and the control group with TB patients (182.68±74.91) pmol/L (t=4.07 and 5.12, respectively, both P<0.01). The level of IL-6 in the control group with TB patients (75.62±75.97) ng/L was higher than that in the study group (51.46±35.86) ng/L and the control group with COPD patients (48.90±30.04) ng/L (t=2.68 and 2.97, respectively, both P<0.01). The level of IFN-γ in the control group with COPD patients (16.60±9.27) ng/L was lower than that in the study group (28.82±32.40) ng/L and the control group with TB patients (29.90±23.79) ng/L (t=2.89 and 3.15, respectively, both P<0.01). Conclusion Compared with the patients in all control groups, the patients with pulmonary TB complicated by COPD in the study group have lower expression in NK cells and T lymphocytes, and an abnormal expression of IL-1, sIL-2R, IL-6 and IFN-γ.

Key words: Tuberculosis, pulmonary/complications, Pulmonary disease, chronic obstructive, Cytokines

中图分类号:

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张占军，姚岚，唐神结. 慢性阻塞性肺疾病合并肺结核患者部分细胞因子水平的表达及其意义[J]. 中国防痨杂志, 2014, 36(3): 189-193. doi: 10.3969/j.issn.1000-6621.2014.03.010

ZHANG Zhan-jun, YAO Lan, TANG Shen-jie. Expression and significance of cytokines in patients with chronic obstructive pulmonary disease complicated with pulmonary tuberculosis[J]. Chinese Journal of Antituberculosis, 2014, 36(3): 189-193. doi: 10.3969/j.issn.1000-6621.2014.03.010

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