To Assess The Prognosis Of The Aecopd Patients By T Lymphocyte Subpopulations

BackgroundCOPD,the full name is Chronic Obstructive Pulmonary Disease,is a kind of common,frequently-occurring disease in respiratory system,which has a high mortality rate,influence the patient's quality of life seriously,detrimental to human health, and bring heavy economic burden to the family and the society.Each year,the COPD patients would have acute exacerbation 0.5 ~ 3.5times.Bacteria,virus infection,air pollution were the main cause of the acute exacerbation of COPD,and it would lead the deterioration of the lung function continuesly, speeding up the disease progression.Bacteria and viruses in the upper respiratory cause a specific immune response and Neutrophilic inflammation,aggravate the airway inflammation,decline the body's immune function,increase and promote the progress of COPD.At the same time,the body's decline immune function is the immediate cause of the COPD patients easy to recurrent respiratory tract infection to acute exacerbation.The inflammatory cells in COPD patient'lungs are alveolar macrophages ?neutrophils and T lymphocytes(especially CD8+ T lymphocytes),the activationinflammatory cells release a variety of inflammatory mediators,include leukotriene-B4?Interleukin-8,Tumor Necrosis Factor Alpha,etc.They will damage the structure of the lung,and/or promote the neutrophilic inflammation,lead to abnormal immune function.In recent years,a number of studies show that both at home and abroad:The COPD patients have primary immune dysfunction,especially the cellular immune dysfunction,T lymphocyte subsets ratio.So,for the patients of AECOPD(the Acute Exacerbation Of Chronic Obstructive Pulmonary Disease),to monitor the cellular immune function is help to elucidate the pathogenesis,and which has important guiding significance in evaluation severity of the disease,observation curative effect and judgement prognosis,etc.At the same time,it can also be used as the basis for immune therapy.Improving the immune function of the patients of COPD is expected to enhance its ability to withstand repeated infection,and is helped to improve the therapeutic efficacy of clinical comprehensive treatment.PurposeTo investigate the value of T lymphocyte subpopulations in evaluating the severity and prognosis of the AECOPD patients,which has put forward the guiding significance in clinical judgment of the severity and prognosis of AECOPD.MethodsUsing the prospective observational study,we selected 80 subjects as AECOPD group from The First Affiliated Hospital Of Zhengzhou University Respiratory and critical care medicine from August 2014 to February 2015.Then,according to the result, divided them into two group:The improvement group(n=69),and The deterioration group(n=8),3 cases discharged because of the death or the pathients left hospital without cure within 7 days of hospitalization.At the same time,40 healthy subjects were chosen as Control group from Medical Center of The First Affiliated Hospital Of Zhengzhou University.To the AECOPD group,the nurses drawed off 2ml blood frow peripheral venous when the patients didn't have breakfast before and aftertratement,to the Control people,the nurthe got the sample when they to have the physical examination.T lymphocyte subsets were determinated by the flow cytometry automatic analysis software of the BD company.All the data were analysis according to the characteristics of data using SPSS 17.0 software.Used the mean ± standard deviation( c±s)to express the measurement data,used the independent sample t test for the comparison between groups.The differences were statistically significant if P<0.05.Results(1) In the first day on the hospital,CD3+?CD4+?CD4+/CD8+ of the AECOPD group were lower than the control group's, the control group was lower than the CD8+ of the AECOPD group's,and the difference had statistical significance(P<0.05);(2)In the first day on the hospital,CD3+?CD4+?CD4+/CD8+of the improvement group were higher than the deterioration group's,CD8+of the improvement group was lower than the deterioration group's,the difference had statistical significance(P<0.05);(3)In the improvement group,CD3+?CD4+?CD4+/CD8+ in the seven day were higher than the first day's,CD8+ in the seven day were lower than the first day's,the difference had statistical significance(P<0.05),but in the deterioration group, CD3+?CD4+?CD4+/CD8+ in the seven day were lower than the first day's,CD8+ in the seven day was higher than the first day's,the difference had statistical significance(P<0.05);(4)In the seven day on the hospital,CD3+?CD4+?CD4+/CD8+of the improvement group were lower than the control group's, the control group was lower than the CD8+ of the improvement group's,and the difference had statistical significance(P<0.05);Conclusion1.The cellular immune function of the AECOPD patients was declined,and along with the aggravation of the disease,the cellular immune function would decline continusly;2.The improvment of the immune imbalances of the AECOPD patients prompt the improvement of the prognosis,but the T lymphocytes continuous reducement prompt the poor prognosis.