哮喘患者T细胞亚群数量与FEV1变化的相关性及意义

目的探讨哮喘患者T细胞亚群数量及与肺通气功能指标(FEV1)变化的相关性及其临床意义.方法用流式细胞仪测定并对比分析22例哮喘发作期、22例咳嗽变异型哮喘患者及25例健康正常者外周血T细胞亚群(CD4 、CD8 )与肺通气功能指标(FEV1).结果CD4 :哮喘发作期组与咳嗽变异型哮喘组及正常对照组比较差异无显著性(P＞0.05),但咳嗽变异型哮喘组低于正常对照组(P＜0.01);CD8 :哮喘发作期组低于咳嗽变异型哮喘组及正常对照组(P＜0.01),差异均有显著性.CD4 /CD8 比值:哮喘发作期组高于咳嗽变异型及正常对照组(P＜0.01),咳嗽变异型哮喘组亦高于正常对照组(P＜0.01),差异均有显著性.1 s用力呼气容积(FEV1)与CD8 呈显著正相关(r=0.57,P＜0.01)与CD4 /CD8 比值呈显著负相关(r=-0.62,P＜0.01).结论哮喘患者CD,阳性细胞百分率下降,CD4 /CD8 细胞比值失衡,患者体内细胞免疫功能异常,可能是哮喘容易反复发作、导致肺通气功能进一步减退的原因.在治疗哮喘病过程中,除对症处理外,应该配合调节细胞免疫功能的药物,以改善肺通气功能.

Correlation and significance of changes of T lymphocyte subsets and FEV1 in asthmatic patients

Objective: To investigate the relationship between the changes of T lymphocyte subsets and ventilatory function (FEV1) in asthmatic patients and its clinical significance. Methods: Flowcytometry was used to compare and analyze the T lymphocyte subsets (CD4 , CD8 ) in the peripheral blood from 22 acute attack asthmatic patients, 22 asthmatic patients with cough variant asthma and 25 healthy subjects. Indexes of ventilatory function (FEV1) were recorded. Results: There was no significant difference between acute attack patients and cough variant asthma in the percentage of CD4 (P >0.05), as well as the normal control group (P >0.05), but the percentage of CD4 was significantly lower in patients with cough variant asthma than that in the normal control group (P <0.01). The percentage of CD8 was significantly lower in acute attack patients than that in the normal control group as well as that in the patients with cough variant asthma (P <0.01); the percentage of CD8 was significantly lower in cough variant asthma than in the normal control group (P <0.01). The ratio of CD4 /CD8 in acute attack asthmatic patients was significantly higher than that in the patients with cough variant asthma and the normal control group (P <0.01). And the ratio of CD4 /CD8 in the patients with cough variant asthma was higher than that in the normal control group (P <0.01). The correlation analysis showed that the value of FEV1 (forced expiratory volume in 1 second) had significantly positive relation with CD8 (r=0.57, P <0.01), but had a significantly negative correlation with the ratio of CD4 /CD8 (r=-0.62, P <0.01). Conclusions: The decrease of CD8 cells, the imbalance in the ratio of CD4 /CD8 and the disturbance of the immune system in asthmatic patients may result in the recurrence of asthma and further deterioration of ventilatory functions. Therefore, to improve their ventilatory functions, immunity-regulating drugs must be used in addition to routine therapy.