Abstract：【Objective】Objective to investigate the relationship between the level of peripheral blood eosinophils (EOS) and Th1/Th2 cytokines in elderly patients with chronic obstructive pulmonary disease (COPD) complicated with asthma. 【Methods】 Elderly COPD patients with asthma (combined group) diagnosed and treated in the geriatric Respiratory Department of the Affiliated Hospital of Yan'an University from August 2017 to August 2019 were selected. In addition, gender and age-matched patients with bronchial asthma and COPD diagnosed and treated in the same hospital in the same period were selected as asthma group (70 cases), COPD group (70 cases) and 70 healthy volunteers as the control group.The levels of EOS and Th1/Th2 cytokines [interferon -γ(INF- γ), Interleukin-6 (IL-6), IL-8, tumor necrosis factor-α(TNF-α)] in peripheral blood of each group were detected and compared. Pearson analyzed the correlation between EOS and Th1/Th2 cytokines. The patients in the combined group were followed up for 1 year. According to the acute attack of the patient's condition, they were divided into frequent acute attack group (acute exacerbation > 1 time) and non frequent acute attack group (acute exacerbation ≤ 1 time). The levels of EOS, Th1/Th2 cytokines and other data in the two groups were compared. The risk factors of COPD complicated with asthma were analyzed by multivariate logistic regression. 【Results】 The levels of EOS TNF -α,IL-6 and IL-8 in the combined group, asthma group, COPD group and control group decreased in turn, and IFN-γ levels increased in turn, and there was significant difference between the groups (P<0.05). Pearson correlation analysis showed that EOS level was negatively correlated with TNF-α(P<0.05) and were positively correlated with IFN-γ, IL-6 and IL-8 (P<0.05). Univariate analysis showed that the age, length of hospital stay, EOS, leukocyte count, lymphocyte count and IL-6 in the frequent acute attack group were significantly higher than those in the non frequent acute attack group (P<0.05). IFN-γ, the percentage of forced respiratory volume in the predicted value in the first second (FEV1%) and the ratio of forced respiratory volume to forced vital capacity in the first second (FEV1/FVC) were significantly lower than those in the non frequent acute attack group (P<0.05); Multivariate logistic regression analysis showed that age, length of hospital stay, EOS and IFN-γ,FEV1% was a risk factor for frequent acute attack of COPD complicated with asthma (P<0.05). 【Conclusion】The level of EOS in peripheral blood in Th1/Th2 cytokines in elderly COPD patients with asthma was negatively correlated with IFN -γand positively correlated with TNF-α, IL-6 and IL-8 . Moreover, peripheral blood EOS and IFN-γare all risk factors affecting patients with frequent acute attacks, which can provide reference for disease diagnosis, treatment and prognosis.
吴晓虹, 白金娥. 老年COPD合并哮喘患者外周血嗜酸性粒细胞水平与Th1/Th2细胞因子的关系[J]. 医学临床研究, 2021, 38(11): 1655-1658.
WU Xiao-hong, BAI Jin-e. Relationship between Peripheral Blood Eosinophils and Th1/Th2 Cytokines in Elderly Patients with COPD Complicated with Asthma. JOURNAL OF CLINICAL RESEARCH, 2021, 38(11): 1655-1658.
[1] BARNES P J. Targeting cytokines to treat asthma and chronic obstructive pulmonary disease[J].Nat Rev Immunol,2018, 18(7):454-466. [2] 柯勰, 刘先胜. 2014全球哮喘处理和预防策略解读[J].临床内科杂志, 2014, 31(12):863-864. [3] SPOSATO B, SCALESE M, MILANESE M, et al. Should omalizumab be used in severe asthma/COPD overlap?[J].J Biol Regul Homeost Agents,2018, 32(4):755-761. [4] BOZ.EK A, ROGALA B. IgE-dependent sensitization in patients with COPD[J].Ann Agric Environ Med,2018, 25(3):417-420. [5] 中华医学会呼吸病学分会哮喘学组. 支气管哮喘防治指南(2016年版)[J].中华结核和呼吸杂志, 2016, 39(9):675-697. [6] 中华医学会呼吸病学分会慢性阻塞性肺疾病学组. 慢性阻塞性肺疾病诊治指南(2013年修订版)[J].中华结核和呼吸杂志, 2013, 36(4):255-264. [7] 杨士芳, 高兴林, 吴健, 等. 多层螺旋CT肺气肿指数在预测COPD急性加重风险中的应用[J].华中科技大学学报(医学版), 2013, 42(6):676-680. [8] HIKICHI M, HASHIMOTO S, GON Y. Asthma and COPD overlap pathophysiology of ACO[J].Allergol Int,2018, 67(2):179-186. [9] 曹玉雪, 吴金峰, 李秋平, 等. T淋巴细胞介导的免疫失衡在慢性阻塞性肺疾病发病中的作用[J].老年医学与保健, 2020, 26(1):151-154. [10] 郑颖妮. IL-4,IL-6,IL-8在慢性阻塞性肺疾病患者血清中的表达及其临床意义[J].医学临床研究, 2020, 37(1):6-8. [11] 王莉,王小军. 外周血嗜酸性粒细胞与哮喘-慢阻肺重叠的关系研究[J].临床输血与检验, 2020, 22(2):200-202. [12] LEE S Y, KANG B, BOK S H, et al. Macmoondongtang modulates Th1-/Th2-related cytokines and alleviates asthma in a murine model[J].PLoS One,2019, 14(12):e0224517.
2021, Vol. 38 
