The Comprehensive Assessment Of Chronic Obstructive Pulmonary Disease And Peripheral Blood Lymphocyte Immune Classification Relationship

Background and ObjectiveChronic obstructive pulmonary disease(Chronic obstructive pulmonary disease COPD) is a serious hazard to human health, it ranked fourth disease leading cause of death in the world, At present some preliminary results show immune cells involved in COPD etiology, pathogenesis, and prognosis of the entire recovery process. If measured by lymphocyte subsets of patients with COPD to assess immune function, immune function to guide the clinical application of drugs, so that patients with COPD improve the immune function, enhance disease resistance has important practical significance. Clinical studies suggest that airway inflammation by immune inhaled corticosteroids, systemic corticosteroids if necessary for the control of airway inflammation, reducing COPD exacerbations and reduce mortality play an important role. However, glucocorticoids could control inflammation, but also have many side effects. Therefore, if through laboratory tests to accurately determine the main airway inflammation to infection, injury or immune-based, or both co-exist, for clinical application of hormone timing is important. Now this article by detecting immunophenotyping changes in peripheral blood lymphocytes of patients with COPD, understand the changes in T cells, B cells, NK cells in patients with acute exacerbation of COPD, and COPD patients with acute exacerbation of pulmonary function, blood gas analysis, respiratory correlation difficulty rating scale, duration and other indicators of changes in their immune function, provide a reference value for clinical diagnosis and treatment of COPD comprehensive.Methods:The subjects selected from December 2014 to September 2015 during the stay of Jilin University in Japan Friendship Hospital in patients with chronic obstructive pulmonary disease in 137 cases, the diagnostic criteria are in line with the 2014 revised edition Global Initiative of Chronic Obstructive Pulmonary Disease and the Chinese Society of Respiratory Diseases Society in 2013 revised edition of chronic obstructive pulmonary disease treatment guidelines: a chronic cough clinic, sputum, dyspnea history, past history of smoking may be hazardous, environment, occupational exposure history and other exposures, bronchial dilation test findings are shown FEV1 / FVC(forced expiratory volume in 1 second / forced vital capacity) <70%, all patients were informed consent for the test items. Recording patients generally include duration of disease, smoking history, height, weight, age, sex, hypertension, diabetes, coronary heart disease and other diseases, while select height, weight, age, sex ratio, and other non-smoking 25 cases not significant differences in healthy controls. According lung function in patients with COPD FEV1 percent predicted numerical results, the patients were divided intoⅠ,Ⅱ,Ⅲ,Ⅳfour groups, based on the results of blood gas analysis patients were divided into group without respiratory failure and respiratory failure group, according to the modified version British Medical Research Council’s respiratory questionnaire(breathlessness measurement using the modified British Medical Reseach Council, m MRC) dyspnea ratings were divided into mild, moderate, severe, very severe four groups, according to the patients disease duration were divided into less than or equal to 10 years, 10--20 years, greater than or equal to 20 years of the three groups were observed in patients with different groups of peripheral blood lymphocytes immunophenotype CD3 +, CD3 + CD4 +, CD3 + CD8 +, CD3-CD19 +, CD3-CD56 +, CD3 + CD4 + / CD3 + CD8 + change compared between groups with each other, while compared with the control group. in patients with acute exacerbation of COPD lymphocyte immune typing indicators as dependent variables, FEV1Pred%, Pa O2, Pa CO2, m MRC score, duration, smoking, etc. are used as independent variables, correlation analysis of clinical data using Graph Pad In Stat software package for data analysis. descriptive research measurement data were normal and non-normal distribution caught as mean ± standard deviation( s X±),count data using rate(%) of the measurement data represents normal person, when homogeneity of variance between groups using t test; when heterogeneity of variance between groups using Welch’s t-test; non-normal distribution of measurement data by using a Mann whitney u test. count data using X2 test. correlation analysis, using multiple correlation analysis, statistical data using SPSS 19.0 software package processed.P≤0.05 considered statistically significant, P ≤ 0.01 think the difference was significant statistical significance.The results of the study:1. COPD patients with acute exacerbation, CD3 +, CD3 + CD4 + lymphocytes without respiratory failure than respiratory failure group and the control group were significantly higher(p <0.05 or p <0.01). CD3 + CD4 + / CD3 + CD8 + ratio without respiratory failure group than in the control group was significantly higher(p <0.05). CD3 + CD8 +, CD3-CD19 +, CD3-CD56 + between each group compared to peripheral blood lymphocyte immune typing all indicators were not significantly different(p> 0.05).2. COPD patients with acute exacerbation, CD3 + CD4 + lymphocyte m MRC2 level group than in the control group was significantly higher(p <0.05); CD3 + CD56 + m MRC3-4 level was significantly higher(p <0.05) compared with m MRC1 level group. CD3 +, CD3 + CD8 +, CD3 + CD19 +, CD3 + CD4 + / CD3 + CD8 + compared to peripheral blood lymphocyte immune typing all indicators were not significantly different(p> 0.05) between the ratio of each group.3. COPD patients with acute exacerbation, CD3 + CD4 + lymphocytes in lung function level III group compared with the control group was significantly higher(p <0.05), in addition, various other peripheral blood lymphocytes immunophenotype index compared among groups, There was no significant difference.4. COPD patients with acute exacerbation, CD3 + CD4 +, CD3 + CD4 + / CD3 + CD8 + ratio, duration of 10--20 years group than in the control group was significantly higher(p <0.05), except addition, among the rest of the group compared to various other immune typing of peripheral blood lymphocytes were not significantly different.5. Peripheral blood CD3 + CD4 + and Pa O2 was a significant positive correlation(P <0.05); CD3 + CD8 + and Pa CO2 was a significant positive correlation(P <0.05), but CD4 + / CD8 + and Pa CO2 was a significant negative correlation(P <0.05); CD3 + CD56 + and m MRC score was a significant positive correlation(P <0.01), CD3 + was a significant negative correlation(P <0.05) and m MRC score.Conclusion:1, Patients with acute exacerbation of COPD without respiratory failure, peripheral blood CD3 +, CD3 + CD4 + lymphocytes, CD3 + CD4 + / CD3 + CD8 + ratio was significantly higher; COPD lung function class III patients also CD3 + CD4 + lymphocytes increased mainly; difficulty breathing Rating m MRC2 level group to CD3 + CD4 + lymphocytes increased mainly, m MRC3-4 level group to CD3 + CD56 + increased mainly; duration of 10--20 years group CD3 + CD4 +, CD3 + CD4 + / CD3 + CD8 + ratio was significantly higher; however, mainly involved in the humoral immune response of CD3 + CD19 + lymphocytes were no significant differences between the groups of the observed indicators.2, Arterial Pa O2, Pa CO2 and peripheral blood CD3 + CD4 +, CD3 + CD8 + lymphocytes, CD4 + / CD8 + ratio is closely related to, m MRC score and CD3 + CD56 +, CD3 + lymphocytes have a certain relevance.3, The conclusion prompted that COPD patients with stage III lung function before respiratory failure have obvious lymphocyte immune dysfunction, the lymphocytes that involved in the humoral immune response was normal, indicating that the cellular immune abnormalities play an important role in the progression of airway inflammation, clinical does not appear for the cellular immune abnormalities caused by airway inflammation, should be given full attention, and promptly correct the abnormal immune response, thereby controlling the disease process of COPD.