COPD患者血清IL-17A 和CXCL12浓度与病情及淋巴滤泡生成的关系

目的：探讨慢性组塞性肺疾病（COPD）患者血清白细胞介素‐17A（IL‐17A）和趋化因子CXCL12水平的变化及其与病情、淋巴滤泡生成的关系。方法选取2014年1月1日至2015年1月1日该院收治的急性加重期COPD患者88例为研究对象，根据COPD分级将其分为轻度组（n＝23）、中度组（n＝42）和重度组（n＝23）3个亚组，另根据淋巴滤泡生成情况将其分为淋巴滤泡组（n＝21）和非淋巴滤泡组两个（n＝67）亚组。采用酶联免疫吸附试验检测各组急性加重期和稳定期血清IL‐17A和趋化因子CXCL12水平并检测同期肺功能，分析COPD患者血清IL‐17A和CXCL12水平与其病情、淋巴滤泡生成及肺功能的关系。结果与轻度组比较，中度组与重度组急性加重期和稳定期患者血清IL‐17A和CXCL12水平均升高，1 s用力呼气容积（FEV1）和用力肺活量（FVC）均降低；与中度组比较，重度组患者血清LI‐17A和CXCL12水平均升高，FEV1和FVC均降低（P＜0．05）。与非淋巴滤泡组比较，淋巴滤泡组急性加重期和稳定期患者血清IL‐17A和CXCL12水平均升高，FEV1和FVC均降低（P＜0．05）。相关性分析结果显示：COPD患者血清IL‐17A和CXCL12水平与其病情严重程度及淋巴滤泡生成率均呈正相关（IL‐17A ：r值分别为0．728、0．762；CXCL12：r值分别为0．752、0．776，P＜0．05），与 FEV1和 FVC均呈负相关（IL‐17A ：r值分别为－0．756、－0．783；CXCL12：r值分别为－0．743、－0．767，P＜0．05）。结论 COPD患者血清IL‐17A和CXCL12水平与其病情、肺功能及淋巴滤泡生成相关，可能作为患者病情、肺功能及淋巴滤泡生成的评估参考指标。

Correlation of serum concentrations of IL-17A and CXCL12 with illness severity,formation of lymph follicles in patients with COPD

Objective To investigate the change of serum concentrations of IL‐17A and CXCL12 in patients with chronic ob‐structive pulmonary disease(COPD) and its correlation with illness severity and formation of lymph follicles .Methods Totally 88 cases of patients with COPD in acute phase in our hospital from 1 January 2014 to 1 January 2015 were selected as the research sub‐jects ,and were divided into mild group(n= 23) ,moderate group(n= 42) and severe group(n= 23) according to the severity of COPD ,and were divided into lymph follicles group(n=21) and non lymph follicles group(n=67) according to lymphoid follicles formation .Enzyme‐linked immunosorbent method was applied to detect the serum IL‐17A and CXCL12 concentrations of these groups in acute aggravating period and stability period ,and parameters of pulmonary function in the same period were also detected . The correlations of serum concentrations of IL‐17A and CXCL12 with illness severity ,formation of lymph follicles and lung function in patients with COPD were analysed .Results Compared with mild group ,serum concentrations of IL‐17A and CXCL12 of moder‐ate group and severe group in acute aggravating period and stable period were increased ,while FEV1 and FVC of medium group and severe group in the same period were decreased;compared with the moderate group ,serum concentrations of IL‐17A and CXCL12 of severe group in acute aggravating period and stable period were increased ,while FEV1 and FVC of severe group in the same period were decreased (P<0 .05) .Compared with non lymph follicles group ,serum concentrations of IL‐17A and CXCL12 of lymph folli‐cles group in acute aggravating period and stable period were increased ,while FEV1 and FVC of lymph follicles group in the same period were decreased (P<0 .05) .The results of correlation analysis showed that serum concentrations of IL‐17A and CXCL12 in patients with COPD were positively correlated to the illness severity and lymph follicle formation rate(IL‐17A :r=0 .728 ,0 .762 ;CXCL12 :r=0 .752 ,0 .776 ,P<0 .05) ,while were negatively correlated to FEV1 and FVC(IL‐17A :r= -0 .756 ,-0 .783 ;CXCL12 :r= -0 .743 ,-0 .767 ,P<0 .05) .Conclusion Serum concentrations of IL‐17A and CXCL12 in patients with COPD were associated with its illness severity ,pulmonary function and lymphoid follicles formation ,which may serve as a reference indexes for the assess‐ment of the illness severity ,pulmonary function and lymph follicle formation .