【摘要】 目的探讨吸烟相关慢性阻塞性肺疾病(COPD)肺微生态菌群、调节性T淋巴细胞(Treg)/辅助性T细胞17(Th17)、炎症之间关系及在发病中的作用机制。方法选取本院COPD稳定期患者68例、肺功能正常者68例,根据是否吸烟将COPD稳定期患者分为吸烟COPD组(n=20)、戒烟COPD组(n=29)、不吸烟COPD组(n=19);肺功能正常者分为吸烟肺功能正常组(n=16)、戒烟肺功能正常组(n=18)、不吸烟肺功能正常组(n=14)。比较6组基线资料、外周血和肺泡灌洗液(BAL)中Treg/Th17、炎性因子、BAL中肺微生态菌群多样性,分析肺微生态菌群、Treg/Th17、炎症因子之间关系及与吸烟的相关性。结果 Chao指数、外周血和BAL中Treg/Th17、IL-10、IL-35指标在各组间比较,吸烟COPD组<戒烟COPD组<非吸烟COPD组<吸烟肺功能正常组<戒烟肺功能正常组<非吸烟肺功能正常组,Simpson指数在各组间比较,吸烟COPD组>戒烟COPD组>非吸烟COPD组>吸烟肺功能正常组>戒烟肺功能正常组>非吸烟肺功能正常组,差异有统计学意义(P<0.05);吸烟与Chao指数、外周血和BAL中Treg/Th17、IL-10、IL-35呈负相关,与Simpson指数、外周血和BAL中IL-17、IL-6、IL-8呈正相关(P<0.05);肺微生态菌群多样性、Treg/Th17、炎性之间存在良好线性相关性(P<0.05)。结论肺微生态菌群失衡、Treg/Th17紊乱、炎症之间相互影响可能在吸烟相关COPD发病机制中起着重要作用。更多还原

【Abstract】 Objective To investigate the relationship between smoking-related chronic obstructive pulmonary disease(COPD)lung microbiota,regulatory T cell(Treg)/helper T cell 17(Thelper17,Th17),and inflammation Relationship and mechanism of action in pathogenesis. Methods 68 patients with stable COPD and 68 patients with normal lung function were selected and divided into smoking COPD group(n=20),smoking cessation COPD group(n=29)and non = smoking COPD group(n=19)according to whether they smoked or not;The patients with normal lung function were divided into smoking group(n=16),smoking cessation group(n=18)and non = smoking group(n=14). Baseline data,Treg/Th17,inflammatory factors in peripheral blood and bronchoalveolar lavage fluid(BAL)and diversity of pulmonary microbiota in BAL were compared among the six groups. The relationship between pulmonary microbiota,Treg/Th17,inflammatory factors and smoking was analyzed. Results Chao index,Treg/Th17,IL=10,and IL=35 in peripheral blood and BAL were compared among the groups. Smoking COPD group <Smoking cessation COPD group <Non=smoking COPD group <Smoking pulmonary function normal group <Smoking cessation pulmonary function normal group <Non=smokers with normal lung function group,Simpson index is compared between each group,smoking COPD group> smoking cessation COPD group> non=smoking COPD group> smoking normal lung function group> smoking cessation normal lung function group>non=smoking normal lung function group,The difference was statistically significant(P<0.05);Smoking was negatively correlated with Chao index,Treg/Th17,IL=10 and IL=35 in peripheral blood and BAL,and positively correlated with Simpson index,IL=17,IL=6 and IL=8 in peripheral blood and BAL(P<0.05);There was a good linear correlation among pulmonary microbial diversity,Treg/Th17 and inflammation(P<0.05). Conclusion The imbalance of pulmonary microbiota,Treg/Th17 disorder,and inflammation may play an important role in the pathogenesis of smoking-related COPD.更多还原