摘要
Abstract
Objective To investigate the laboratory indicators for diagnosis and prognosis of acute exacerbation of chronic obstructive pulmonary disease (COPD).Methods One hundred and forty patients with COPD were diagnosed in our department and classified as acute exacerbation group and stable groups,40 healthy subjects served as control group.The pulmonary function were tested,BODE index was assessed and arterial blood gas analysis was performed in all patients.Serum TNF-α,IL-6,IL-8 levels,the proportion of Th17 and Treg cells,plasma fibrinogen (Fib) in the peripheral blood were measrued and compared.The correlation between above-mentioned indexes and pulmonary function,arterial partial pressure of oxygen,BODE index were analyzed.Results The FEV1％ pre,FEV1/FVC and PaO2 of COPD patients in acute exacerbation were significantly lower than those in stable group and healthy control group,while the BODE index was significantly higher than that in stable group and control group.TNF-α,IL-6,IL-8,Fib,the proportion of Th17 cells and Th17/Treg ratio in acute exacerbation group were significantly higher than those in stable group and control group,while the proportion of Treg cells was significantly lower than that in stable group and control group (P＜0.05).TNF-α,IL-6,and Th17/Treg ratio in Grade Ⅲ COPD patients were significantly higher than those in grade Ⅱ group,while the proportion of Treg cells was significantly lower than that of grade Ⅱ COPD patients (P＜0.05).TNF-α,IL-8,the proportion of Th17 cells,Th17/Treg ratios and Fib in Grade Ⅳ COPD patients were significantly higher than those in Grade Ⅲ group,while the proportion of Treg cells was significantly lower than that in Grade Ⅲ group (P＜0.05).Spearman correlation analysis showed that,only TNF-α,Th17/Treg ratios and Fib had significant correlation with FEV1％ pre,FEV1/FVC,PaO2 and the BODE index,and the TNF-α,Th17/Treg and Fib had the strongest correlation with BODE index (P＜0.05).The combination of TNF-α,Th17/Treg and Fib had the highest sensitivity and accuracy in the diagnosis of acute exacerbation (P＜0.05).Conclusion COPD patients have high blood coagulation and inflammation factor content,and imbalanced Th17/Treg ration and immune excessive state.Combined detection of TNF-α,Th17/Treg and Fib has higher sensitivity and accuracy in diagnosis of acute exacerbations and prognosis of COPD patients.关键词
慢性阻塞性肺疾病/炎症因子/Th17细胞/Treg细胞/纤维蛋白原Key words
Chronic obstructive pulmonary disease/Inflammatory cytokines/Th17 cells/Treg cells/Fibrinogen
