慢性阻塞性肺病合并细菌感染患者CD4<sup>+</sup>CD25<sup>+</sup>T调节细胞及相关细胞因子表达水平及意义

doi:10.3969/j.issn.1006-6233.2023.06.013

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摘要 目的: 研究慢性阻塞性肺病(COPD)合并细菌感染患者CD4⁺CD25⁺T调节细胞及其相关细胞因子白介素-4(IL-4)、IL-12和γ-干扰素(IFN-γ)表达水平及临床意义。方法: 纳入2020年8月至2022年8月间收治的108例COPD患者作为研究对象,根据是否合并细菌感染分为感染组(n=53)和对照组(n=55)。检测外周血标本CD4⁺CD25⁺调节性T细胞以及IL-4、IL-12和IFN-γ表达水平,对比两组差异,并分析相关指标水平与COPD合并感染的关系;统计患者28d预后情况,分析上述指标对患者预后预测价值。结果: 感染组COPD患者血清IL-4、IL-12水平高于对照组,IFN-γ/IL-4低于对照组,差异有统计学意义(P<0.05);随访结果显示28d内死亡15例,病死率13.89%;死亡组COPD患者血清IL-4水平高于对照组,CD4⁺CD25⁺、IL-12、IFN-γ和IFN-γ/IL-4低于对照组,差异有统计学意义(P<0.05);logistics回归分析结果显示,血清IL-4和IL-12水平与COPD合并肺部感染存在关联(P<0.05),CD4⁺CD25⁺、IL-12和IFN-γ/IL-4与COPD患者预后存在关联(P<0.05);ROC曲线显示,CD4⁺CD25⁺、IL-12、IFN-γ/IL-4及三者联合检测对COPD患者预后判断的AUC分别为0.747、0.827、0.709和0.924。结论: CD4⁺CD25⁺Treg及相关细胞因子与COPD感染和病情进展有关,检测CD4⁺CD25⁺Treg分布以及IL-4、IL-12和IFN-γ可为COPD患者肺部感染诊断和预后评估提供参考信息。

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	邢贞泉
	赵光强
	李柳霞

关键词 ：慢性阻塞性肺病, 调节性T淋巴细胞, 白介素-4, 干扰素γ

Abstract：Objective: To study the expression levels and clinical significance of CD4⁺CD25⁺T regulatory cell and related cytokines of interleukin-4 (IL-4), IL-12 and interferon-γ (IFN-γ) in patients with chronic obstructive pulmonary disease (COPD) complicated with bacterial infection. Methods: A total of 108 patients with COPD admitted between August 2020 and August 2022 were included as the research subjects, and they were divided into infected group (n=53) and control group (n=55) according to whether the patients were complicated with bacterial infection. The expression levels of CD4⁺CD25⁺ regulatory T cell and IL-4, IL-12 and IFN-γ were detected in the peripheral blood samples, and the differences between the two groups were compared, and the relationship between levels of related indicators and COPD with infection was analyzed. The 28-d prognosis of patients was statistically analyzed, and the predictive value of the above indicators on prognosis was analyzed. Results: The levels of serum IL-4 and IL-12 of COPD patients in infected group were higher than those in control group while the IFN-γ/IL-4 was lower than that in control group (P<0.05). Follow-up results showed that 15 patients died within 28 d, with a mortality rate of 13.89%. The level of serum IL-4 of COPD patients in death group was higher than that in control group while the levels of CD4⁺CD25⁺, IL-12, IFN-γ and IFN-γ/IL-4 were lower than those in control group (P<0.05). Logistics regression analysis showed that serum levels of IL-4 and IL-12 were associated with COPD with pulmonary infection (P<0.05), and CD4⁺CD25⁺, IL-12 and IFN-γ/IL-4 were associated with the prognosis of COPD patients (P<0.05). ROC curve showed that the AUC values of CD4⁺CD25⁺, IL-12, IFN-γ/IL-4 and the combination of the three were 0.747, 0.827, 0.709, and 0.924 respectively in judging prognosis of COPD patients. Conclusion: CD4⁺CD25⁺ Treg cell and related cytokines are related to COPD infection and disease progression. Detection of CD4⁺CD25⁺ Treg distribution as well as IL-4, IL-12 and IFN-γ can provide reference information for diagnosis of pulmonary infection and evaluation of prognosis in patients with COPD.

Key words： Chronic obstructive pulmonary disease Regulatory T lymphocytes Interleukin-4 Interferon-γ

基金资助:海南省自然科学基金面上项目,(编号:821MS162)

通讯作者: 赵光强

引用本文:

邢贞泉, 赵光强, 李柳霞. 慢性阻塞性肺病合并细菌感染患者CD4⁺CD25⁺T调节细胞及相关细胞因子表达水平及意义[J]. 河北医学, 2023, 29(6): 947-951.
XING Zhenquan, ZHAO Guangqiang, LI Liuxia. Expression Levels and Significance of CD4⁺CD25⁺T Regulatory Cell and Related Cytokines in Patients with COPD Complicated with Bacterial Infection. HeBei Med, 2023, 29(6): 947-951.

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http://www.hbyxzzs.cn/CN/10.3969/j.issn.1006-6233.2023.06.013 或 http://www.hbyxzzs.cn/CN/Y2023/V29/I6/947

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