Expression of serum interleukin-19 and interleukin-21 in patients with chronic obstructive pulmonary disease and their relationship with immune function
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摘要: 目的 观察慢性阻塞性肺疾病(COPD)患者血清白细胞介素-19(IL-19)、白细胞介素-21(IL-21)水平，并分析两者与患者免疫功能的关系。方法 选择2020年4月至2022年1月收治的120例COPD患者为研究对象，所有患者均参照《慢性阻塞性肺疾病诊治指南(2013版)》给予常规治疗，采集患者入院时、入院7 d、14 d空腹静脉血，检测患者IL-19、IL-21及免疫功能指标T淋巴细胞亚群CD3+、CD4+、CD8+，分析COPD患者血清IL-19、IL-21与免疫功能的关系。结果 入院7 d、14 d时，患者IL-19、IL-21、CD8+水平较入院时逐步降低，CD3+、CD4+与入院时比较逐步升高，差异有统计学意义(P < 0.05)；经广义估计方程分析，以入院时作为参照，以IL-19作为协变量，COPD患者入院7 d时CD3+、CD4+分别升高4.790%、14.106%，14 d时CD3+、CD4+分别升高13.573%、19.964%，CD8+降低5.345%(P < 0.05)；以IL-21作为协变量，COPD患者入院7 d时CD3+、CD4+分别升高6.942%、21.275%，14 d时CD3+、CD4+分别升高15.058%、23.738%，CD8+降低2.633%(P < 0.05)。COPD患者CD3+、CD4+、CD8+T淋巴细胞水平与IL-19、IL21水平有关(P < 0.05)。结论 COPD患者血清IL-19、IL-21水平随着治疗时间延长而逐渐降低，且二者表达水平与CD3+、CD4+呈负相关，与CD8+呈正相关。Abstract: Objective To observe the levels of serum interleukin-19(IL-19) and interleukin-21(IL-21) in patients with chronic obstructive pulmonary disease(COPD), and analyze the relationship between them and immune function.Methods A total of 120 COPD patients admitted from April 2020 to January 2022 were selected as the research subjects. All patients were given routine treatment according to the Guidelines for the Diagnosis and Treatment of Chronic Obstructive Pulmonary Disease(2013 Edition) . Fasting venous blood was collected at admission, 7 d and 14 d after admission, and IL-19, IL-21 and immune function indexes(T lymphocyte subsets CD3+, CD4+, CD8+)were detected. The relationship between serum IL-19, IL-21 and immune function in patients with COPD was analyzed.Results Seven day and 14 day after admission, the levels of IL-19, IL-21 and CD8+were gradually decreased than those at admission, and the levels of CD3+and CD4+were gradually increased than those at admission, the difference was statistically significant(P < 0.05). By generalized estimating equation analysis, with admission as reference and IL-19 as covariate, CD3+and CD4+of COPD patients increased by 4.790% and 14.106% respectively on the 7th day of admission, and increased by 13.573% and 19.964% respectively on the 14th day, while CD8+decreased by 5.345%(P < 0.05). IL-21 was used as a covariate, CD3+and CD4+in COPD patients increased by 6.942% and 21.275% on the 7th day after admission, and increased by 15.058% and 23.73% on the 14th day, respectively. CD8+decreased by 2.633%(P < 0.05). The levels of CD3+, CD4+and CD8+T lymphocytes in COPD patients were related to the levels of IL-19 and IL21(P < 0.05).Conclusion The levels of serum IL-19 and IL-21 in COPD patients decreased gradually with the prolongation of treatment time, and the expression levels of the two were negatively correlated with CD3+and CD4+, and positively correlated with CD8+.
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Key words:
- chronic obstructive pulmonary disease /
- immune function /
- interleukin-19 /
- interleukin-21
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表 1 不同时点COPD患者血清IL-19、IL-21与免疫功能水平
X±S 指标 入院时 入院7 d 入院14 d F P IL-19/(pg·mL-1) 81.27±11.64 69.22±10.15 55.64±8.80 187.342 < 0.001 IL-21/(pg·mL-1) 186.08±18.50 162.69±15.06 134.47±14.27 311.152 < 0.001 CD3/% 51.75±4.54 59.62±4.14 64.86±5.05 247.827 < 0.001 CD4/% 27.19±3.17 34.06±4.28 40.83±4.50 344.420 < 0.001 CD8/% 36.24±4.35 30.57±3.52 23.51±3.58 331.814 < 0.001 
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表 2 CD3+T淋巴细胞与IL-19变化关系的广义方程分析
变量 β SE Wald 95%CI Wald χ2 P 截距 82.778 1.682 79.482~86.075 2421.834 < 0.001 入院14 d 13.573 0.713 12.176~14.970 362.659 < 0.001 入院7 d 4.790 1.536 1.779~7.801 9.721 < 0.001 入院时 - - - - - IL-19 -0.382 0.020 -0.421~-0.342 360.321 < 0.001 入院14 d -0.184 0.010 -0.204~-0.165 342.402 < 0.001 入院7 d -0.022 0.018 -0.058~0.014 1.424 < 0.001 入院时 - - - - -
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表 3 CD3+T淋巴细胞与IL-21变化关系的广义方程分析
变量 β SE Wald 95%CI Wald χ2 P 截距 97.078 0.736 95.636~98.520 17417.350 < 0.001 入院14 d 15.058 1.263 12.582~17.533 142.182 < 0.001 入院7 d 6.942 0.921 5.138~8.747 56.857 < 0.001 入院时 - - - - - IL-21 -0.244 0.004 -0.251~-0.236 3717.989 < 0.001 入院14 d -0.108 0.008 -0.124~-0.092 179.948 < 0.001 入院7 d -0.029 0.005 -0.040~-0.019 28.401 < 0.001 入院时 - - - - -
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表 4 CD4+T淋巴细胞与IL-19变化关系的广义方程分析
变量 β SE Wald 95%CI Wald
χ2P 截距 48.859 0.923 47.051~50.668 2803.344 < 0.001 入院14 d 19.964 0.799 18.398~21.530 624.393 < 0.001 入院7 d 14.106 1.191 11.773~16.440 140.389 < 0.001 入院时 - - - - - IL-19 -0.267 0.011 -0.288~-0.245 595.343 < 0.001 入院14 d -0.236 0.014 -0.264~-0.209 279.384 < 0.001 入院d -0.151 0.015 -0.180~-0.122 103.725 < 0.001 入院时 - - - - -
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表 5 CD4+T淋巴细胞与IL-21变化关系的广义方程分析
变量 β SE Wald 95%CI Wald
χ2P 截距 58.635 0.605 57.449~59.820 9396.156 < 0.001 入院14 d 23.738 1.540 20.719~26.757 237.462 < 0.001 入院7 d 21.275 0.578 20.143~22.408 1355.868 < 0.001 入院时 - - - - - IL-21 -0.169 0.003 -0.175~-0.163 2834.005 < 0.001 入院14 d -0.140 0.010 -0.161~-0.106 176.069 < 0.001 入院7 d -0.113 0.003 -0.120~-1.060 1074.691 < 0.001 入院时 - - - - -
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表 6 CD8+T淋巴细胞与IL-19变化关系的广义方程分析
变量 β SE Wald 95%CI Wald χ2 P 截距 6.510 1.327 3.909~9.112 24.056 < 0.001 入院14 d -5.345 0.746 -6.807~-3.883 51.362 < 0.001 入院7 d 0.318 1.471 -2.565~3.201 0.047 0.829 入院时 - - - - - IL-19 0.366 0.016 0.335~0.397 537.903 < 0.001 入院14 d 0.036 0.008 0.021~0.051 21.722 < 0.001 入院7 d -0.023 0.018 -0.058~0.012 1.657 0.198 入院时 - - - - -
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表 7 CD8+T淋巴细胞与IL-21变化关系的广义方程分析
变量 β SE Wald 95%CI Wald χ2 P 截距 -7.111 0.638 -0.835~-5.869 125.877 < 0.001 入院14 d -2.633 1.080 -4.750~-0.516 5.942 0.015 入院7 d -0.147 0.643 -1.408~1.114 0.052 0.819 入院时 - - - - - IL-21 0.233 0.003 0.226~0.240 4650.298 < 0.001 入院14 d 0.014 0.007 0.001~0.028 4.166 0.041 入院7 d ＜0.001 0.004 -0.009~0.007 0.016 0.898 入院时 - - - - -
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