首页|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

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

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目的 探讨血清单核细胞趋化蛋白-1(MCP-1)水平及外周血辅助性T细胞17(Th17)/调节性T细胞(Treg)平衡与老年慢性阻塞性肺疾病(COPD)并发全身炎症反应综合征(SIRS)的关系。方法 选取82例老年COPD合并SIRS患者(SIRS组),以1∶1比例对照选取单纯老年COPD患者(非SIRS组)。采用酶联免疫吸附法与流式细胞术检测血清MCP-1与外周血Th17、Treg比例。通过多因素Logistic回归分析老年COPD并发SIRS的影响因素,受试者工作特征(ROC)曲线分析血清MCP-1水平和外周血Th17/Treg对老年COPD并发SIRS的预测价值。结果 与非SIRS组比较,SIRS组血清MCP-1和外周血Th17、Th17/Treg高,外周血Treg比例低(P<0。05)。Th17高(OR=3。640,95%CI:1。929~6。867)、MCP-1高(OR=1。035,95%CI:1。016~1。054)、Th17/Treg高(OR=3。612,95%CI:1。835~7。107)为老年COPD并发SIRS的独立危险因素,Treg高(OR=0。651,95%CI:0。467~0。907)为独立保护因素(P<0。05)。血清MCP-1水平联合外周血Th17/Treg预测老年COPD并发SIRS的曲线下面积为0。890(95%CI:0。832~0。934),大于血清MCP-1水平、外周血Th17/Treg单独预测(P均<0。05)。结论 血清MCP-1水平升高和Th17/Treg失衡与老年COPD并发SIRS独立相关,血清MCP-1水平联合外周血Th17/Treg检测对老年COPD并发SIRS有较高的预测价值。
Relationships of serum MCP-1 levels and Th17/Treg cell balance with COPD complicated with SIRS in the elderly
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.

chronic obstructive pulmonary diseasemonocyte chemotactic protein-1T helper cells 17/T regulatory cellssystemic inflammatory response syndromeelderly

殷俏、何新霞、王晶、马瑞晓

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河北衡水市人民医院(哈励逊国际和平医院)全科医学科,河北衡水 053000

河北衡水市人民医院(哈励逊国际和平医院)呼吸与危重症科

河北衡水市人民医院(哈励逊国际和平医院)感染性疾病科

慢性阻塞性肺疾病 单核细胞趋化蛋白-1 辅助性T细胞17/调节性T细胞 全身炎症反应综合征 老年人

河北省医学科学研究项目

20232189

2024

山东医药
山东卫生报刊社

山东医药

CSTPCD
影响因子:1.225
ISSN:1002-266X
年,卷(期):2024.64(16)
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