探究慢性阻塞性肺疾病患者血清中T淋巴细胞亚群、CRP、NLR、SII与肺功能分级的相关性及其临床意义

Exploration of the Correlation between Pulmonary Function Grading and T Lymphocyte Subsets, CRP, NLR and SII in the Serum of Patients with Chronic Obstructive Pulmonary Disease and Its Clinical Significance

摘要: 目的：探究慢性阻塞性肺疾病(Chronic obstructive pulmonary disease, COPD)患者血清中T淋巴细胞亚群、CRP、NLR、SII与肺功能分级的相关性，及其对临床中评估COPD患者病情严重程度的价值。方法：收集2021年1月至2024年3月我院收治的68例COPD患者(实验组)和同期住院的非COPD患者32例(对照组)作为研究对象，按照FEV1%预计值将COPD患者分为轻中度组、重度组及极重度组。收集病人住院期间测得的血清CD3 、CD4 T淋巴细胞绝对计数、CRP、IL-6、ESR、PCT，计算中性粒细胞/淋巴细胞比率、系统免疫炎症指数及红细胞分布宽度变异系数等作为观察指标，运用Kruskal-Wallis检验、Mann Whitney U检验、方差分析、Spearman相关分析等统计学方法进行逐层分析。结果：1) 实验组患者血清中CD3 、CD4 T淋巴细胞绝对计数水平均低于对照组，而NLR、SII水平高于对照组(P < 0.05)。2) CRP、NLR及SII在实验组组内之间存在差异，极重度组CRP、NLR及SII均大于轻中度组(P < 0.05)。3) COPD病人的FEV1%与CRP、NLR及SII均呈负相关(r = −0.369、r = −0.302、r = −0.361, P < 0.05)。结论：CRP、NLR及SII在不同肺功能分级COPD患者血清中的表达存在差异，通气功能受损程度严重的COPD病人体内炎症反应水平更高，CRP、NLR及SII对临床评估COPD患者病情严重程度具有重要价值，在临床诊疗过程中应加强监测。

Abstract: Objective: To explore the correlation between pulmonary function grading and serum T lymphocyte subsets, CRP, NLR and SII in patients with chronic obstructive pulmonary disease (COPD), and its value in assessing the severity of COPD. Methods: A total of 68 COPD patients (experimental group) and 32 non-COPD patients (control group) hospitalized in our hospital from January 2021 to March 2024 were collected as the research objects. According to FEV1%pred, the COPD patients were divided into mild-moderate group, severe group and extremely severe group. The counts of CD3 and CD4 T lymphocytes, CRP, IL-6, ESR, PCT, NLR, SII, and red cell distribution width coefficient of variation measured during hospitalization were collected as observation indicators. Kruskal-Wallis test, Mann Whitney U test, Analysis of Variance, Spearman correlation analysis and other statistical methods were used. Results: 1) The counts of CD3 and CD4 T lymphocytes in the experimental group were lower than those in the control group, while the levels of NLR and SII were higher than those in the control group (P < 0.05). 2) There were differences in CRP, NLR and SII within the experimental groups. CRP, NLR and SII in the extremely severe group were higher than those in the mild and moderate group (P < 0.05). 3) FEV1%pred in COPD patients was negatively correlated with CRP, NLR and SII (r = −0.369, r = −0.302, r = −0.361, P < 0.05). Conclusions: There are differences in the expression of CRP, NLR and SII in the serum of COPD patients with different pulmonary function grades. The level of inflammatory response in COPD patients with severe ventilation function impairment is higher. CRP, NLR and SII have important value in clinical evaluation of the severity of COPD, and should be further monitored during clinical diagnosis and treatment.