血清MCP-1水平及外周血Th17/Treg平衡与老年COPD并发全身炎症反应综合征的关系OACSTPCD

Objective To investigate the relationships of serum monocyte chemotactic protein-1(MCP-1)level and T helper cells 17(Th17)/T regulatory cells(Treg)cellular balance with chronic obstructive pulmonary disease(COPD)complicated with systemic inflammatory response syndrome(SIRS)in the elderly.Methods Eighty-two elderly patients with COPD combined with SIRS(SIRS group)were selected,and elderly patients with COPD alone(non-SIRS group)were selected at the case-control ratio of 1∶1.Serum MCP-1 levels and the ratio of Th17 and Treg were measured by enzyme-linked immunosorbent assay and flow cytometry.Logistic regression was used to analyze the factors for COPD com-plicated with SIRS in the elderly,and ROC curves were used to analyze the predictive value of serum MCP-1 and peripheral blood Th17/Treg for COPD complicated with SIRS in the elderly.Results Compared with the non-SIRS group,serum MCP-1 and peripheral blood Th17 and Th17/Treg increased,and the peripheral blood Treg ratio decreased in the SIRS group(all P<0.05).Th17(OR=3.640,95%CI:1.929 to 6.867),MCP-1(OR=1.035,95%CI:1.016 to 1.054),elevated Th17/Treg(OR=3.612,95%CI:1.835 to 7.107)were independent risk factors for COPD complicated with SIRS in the elderly,and elevated Treg(OR=0.651,95%CI:0.467 to 0.907)was an independent protective factor(P<0.05).The area under the curve of serum MCP-1 combined with peripheral blood Th17/Treg in predicting COPD compli-cated with SIRS in the elderly was 0.890(95%CI:0.832 to 0.934),which was greater than that of serum MCP-1[0.786(95%CI:0.715 to 0.846)]and peripheral blood Th17/Treg[0.815(95%CI:0.747 to 0.871)]alone,respectively(both P<0.05).Conclusion The elevated serum MCP-1 level and Th17/Treg cellular imbalance were independently associated with COPD complicated with SIRS in the elderly,and serum MCP-1 combined with peripheral blood Th17/Treg had a high predictive value for COPD complicated with SIRS in the elderly.