血清 MCP-1 水平及外周血 Th17/Treg 平衡与老年 COPD 并发全身炎症反应综合征的关系.

Objective To investigate the relationships of serum monocyte chemotactic protein-1 (MCP-1) level and T helper cells 17 (Th17）/T regulatory cells (Treg) cellular balance with chronic obstructive pulmonary disease (COPD) complicated with systemic inflammatory response syndrome (SIRS) in the elderly. Methods Eighty-two elderly patients with COPD combined with SIRS (SIRS group) were selected, and elderly patients with COPD alone (non-SIRS group) were selected at the case-control ratio of 1∶1. Serum MCP-1 levels and the ratio of Th17 and Treg were measured by enzyme-linked immunosorbent assay and flow cytometry. Logistic regression was used to analyze the factors for COPD com‑ plicated with SIRS in the elderly, and ROC curves were used to analyze the predictive value of serum MCP-1 and peripheral blood Th17/Treg for COPD complicated with SIRS in the elderly. Results Compared with the non-SIRS group, serum MCP-1 and peripheral blood Th17 and Th17/Treg increased, and the peripheral blood Treg ratio decreased in the SIRS group (all P<0. 05）. Th17 (OR=3. 640，95% CI：1. 929 to 6. 867）, MCP-1 (OR=1. 035，95% CI：1. 016 to 1. 054）, elevated Th17/Treg (OR=3. 612，95% CI：1. 835 to 7. 107) were independent risk factors for COPD complicated with SIRS in the elderly, and elevated Treg (OR=0. 651，95% CI：0. 467 to 0. 907) was an independent protective factor (P< 0. 05）. The area under the curve of serum MCP-1 combined with peripheral blood Th17/Treg in predicting COPD complicated with SIRS in the elderly was 0. 890 (95% CI：0. 832 to 0. 934）, which was greater than that of serum MCP-1［0. 786 (95% CI：0. 715 to 0. 846）］ and peripheral blood Th17/Treg ［0. 815 (95% CI：0. 747 to 0. 871）］ alone, respectively (both P<0. 05）. Conclusion The elevated serum MCP-1 level and Th17/Treg cellular imbalance were independently associated with COPD complicated with SIRS in the elderly, and serum MCP-1 combined with peripheral blood Th17/Treg had a high predictive value for COPD complicated with SIRS in the elderly [ABSTRACT FROM AUTHOR]