| Backgroud: Cronic cor pulmonale (CCP) is a kind of chronic disease whichadvances at a certain pace. It is induced by chronic bronchitis, lung,chest and pulmonary artery diseases. As a result the pressure ofpulmonary artery rises, the hypertrophic heart expands and heartfailure. CCP is one of the chronic diseases which harm the publichealth. Even now it is not controled. 80%-90% of it is induced bychronic obstructed pulmonary diseases (COPD). It is respiratory tractinfection that cause acute attacking and the condition worsening tohappen. COPD and CCP are common diseases in aged people.Infection is the main cause of COPD complicated by CCP coming on,aggravating and death. With the enhancing of medical and health work,the condition of patients with COPD and CCP has improved. Manykind of drugs apply to clinical. This prolong the life-span of patientswith COPD and CCP. But the mortality rate of COPD and CCP is stilla higher one because of high incidence,recurrence and long deleyingof it. Many kinds of complications appear frequently. Especiallynowadays antibiotics and hormone are used in clinical widely.Infections become complicated. The state of illness is beyond controlwith appearing of drug-resistant and double infection. Statistics of WHO show that COPD is still the forth reason ofdeath of the world. There is some statistics in some areas of ourcountry. The result is the incidences also high. Now it is puzzles ofclinical as well. There are many causes in the course of CCPaggravating and complicating. Besides of bad habbit of life, poormedical and health work, inheritance, adverse circumstance, there areunreasonable use of antibiotics and hormone, double infection anddrug-resistant. To solve the problems in clinical, patients with CCPough to improve their life and habbit, long-term oxygen-treatment,utilize antibiotics reasonable. Use the doze to make bronchus dilatateetc. With the development of immunology and test method, basic andclinical material show that patients with CCP are in low level atwhite-blood-cell phagocytosis and immunofunction. Especially infunction of cellular immunity. This lead to susceptible to exoticinfection.Therefore the disease aggravate further or cause a long delaying.Although antibiotics-treatment may lysis some clinical symptom, itlose control of the disease to recurring. So it is necessary for patientswith CCP use drugs which can improve the immunofunction. Studythe change of immunoglobulin, T cell subgroups and cytokines ofacute CCP will contribute to judging the state of immunity andguiding clinical treatment. So immunological study of CCP have aimportant clinical meanings.T lymphocyte is the main immunological system. As a importantimmune cells, T lymphocytes play a regulating role. The positive rateof CD series represent the total lymphocyte and subset proportion. Incellular immunity, total T lymphocyte stand for overall immunefunction of lymphocyte. T lymphocyte consisted of differentfunctional subgroup. Among this the most important two subgroup isT helper cell CD4 (Th) and T kill or suppress cell CD8 (Tc). They notonly have influence to cellular immunity, but have influence tohumoral immunological. The value to detect T lymphocyte subgroupis to find the function of immunity adjustment and the dynamicequilibrium state of T helper cell and T suppress cell.Objective:To evaluate the state of immunofunction in patients with CCP bymeans of detecting the changes of T lymphocyte subgroup and thelevel of IL-2.Methods:The proportion of CD3, CD4, CD8 T lymphocyte and NK cells aswell as CD4/CD8 ratio were detected by flow cytometry meanwhilemeasured the level of IL-2 by ABC-double antibody ELISA.We expoud that patients with CCP are low in immuno-functionand abnormal in adjustment function.We detect the counts of CD3,CD4, CD8, NK cells and the CD4/CD8 ratio in peripheral blood oftwenty patients during exacerbation and stable stage. Fifteen healthyaged persons were used as controls.Result:During acute exacerbation the levels of IL-2, counts of CD3, CD4and CD4/CD8 ratio were significantly lower than that in remissionstage and nomal subject (P<0.01). On the contrary, proportion of NKascend. The counts of CD8 were also low in some degree. Aftertreatment the levels of T cell subgroups and level of IL-2 were higherthan that before treatment.But it is also lower than those in normalcontrols. The counts of CD8 ascend in some degree or there was nosignificant difference.Conclusion:The materials show that there are immunofunction disorder inpatients with CCP because of T cell subgroup proportion deviating.The patients for test have been infected remarkably, lack of oxygenand high carbonic acid in blood. Tissues and cells especiallylymphocytes can't endure it. Therefore immunofunction become lowerfurther. So infection occure repeatedly. In remission stage, the formersubjects resume in different degree. This show that with the patient'scondition taking a favorable turn, their immunofunction have shownsome improvement. But the proportion of CD3, CD4 are still lowerthan normal control. We conclude that immunofunction in patientswith CCP is still in inhibited state. |
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