呼吸道病毒感染对慢性阻塞性肺疾病急性加重期患者免疫功能影响.docVIP

呼吸道病毒感染对慢性阻塞性肺疾病急性加重期患者免疫功能影响 　 作者：陈纯，黄誉，唐春利， 陈智 【摘要】 　　目的： 探讨呼吸道病毒感染对慢性阻塞性肺疾病急性加重期患者（AECOPD）免疫功能的影响。方法： 收集呼吸道合胞病毒（RSV）、柯萨奇病毒（COX）、流感病毒（Flu）、腺病毒（ADV）特异性抗体IgM阳性的AECOPD患者88例（A组）及特异性抗体IgM阴性的AECOPD患者80例（B组），观察两组临床表现，检测两组患者血液中CD4+、CD8+以及IgG、IgA、IgM的水平。结果： A组64.8%的患者伴有上呼吸道症状、而无脓痰等临床表现，外周血白细胞总数正常者为42例（47.73%）；两组CD+8以及CD4+/CD8+、血清IgG、IgA比较均有显著差异，P＜0.05。CD1+及IgM无显著差异，P＞0.05。结论： 呼吸道病毒感染是影响AECOPD患者免疫功能的重要因素，并可引起其急性加重。 【关键词】 肺疾病 慢性阻塞性 呼吸道病毒感染 免疫球蛋白类 CD4阳性T 淋巴细胞 CD8阳性T淋巴细胞 　　［Abstract］ Objective: To explore the effect of respirovirus infection on immune function in patients of chronic obstructive pulmonary disease with acute exacerbations (AECOPD). Methods: A total of 168 AECOPD patients hospitalized from July 2005 to December 2007 were selected. Respirovirus specific serum IgM antibodies were measured by using chip test; Flow cytometer was used to analyze the frequencies of CD4+ and CD8+ lymphocytes. Of these patients, 88 showed positive reaction in test of specific antigen IgM of RS virus, coxsackie virus, influenza virus, or adenovirus were chosen as group A, while the other 80 patients showed negative in IgM test as group B. The serum CD4+, CD8+ and IgG, IgA, IgM levels of the two groups were compared. Results: 64.8% of the patients in group A had symptoms of upper airway infection, but without purulent sputum. Fourtytwo patients in group A had normal counts of peripheral blood leucocytes.There were significant differences in CD8+ , CD4+/ CD8+ , serum IgG and IgA between groups A and B (Plt;0.05), while no difference in CD4+ or IgM was found (Pgt;0.05). Conclusion: Respirovirus infection is a rather frequent event in AECOPD, and it is an important factor causing disorder of immunity in COPD patients, which might induce acute exacerbation. 　　［Key words］ pulmonary disease,chronic obstructive; respiravirus infection; immunoglobulins; CD4positive T lymphocytes; CT8positive T lymphocytes 　　呼吸道感染是慢性阻塞性肺疾病（COPD）发病和加剧的重要因素。近年来, 呼吸道病毒感染在COPD发病中的作用开始引起重视[1], 但研究仍较少。本实验检测呼吸道合胞病毒(