天津医药

天津医药 ›› 2019, Vol. 47 ›› Issue (11): 1156-1160.doi: 10.11958/20190542

• 临床研究 • 上一篇    下一篇

单核巨噬细胞亚群在结缔组织病相关间质性肺病中的表达研究

王丽平，陈雪芬，赵茂，李学任，刘斌，彭守春   

  1. 1中国人民武装警察部队特色医学中心呼吸与重症医学科（邮编300162）；2中国人民武装警察部队嘉峪关支队卫生队
  • 收稿日期:2019-02-26 修回日期:2019-07-18 出版日期:2019-11-15 发布日期:2019-12-17
  • 通讯作者: 王丽平 E-mail:279910480@qq.com
  • 作者简介:2019年 11期

Research on expression of monocyte/macrophage subsets in patients with connective tissue disease related interstitial lung disease

WANG Li-ping,CHEN Xue-fen,ZHAO Mao,LI Xue-ren,LIU Bin,PENG Shou-chun   

  1. 1 Department of Respiratory and Critical Care Medicine, Characteristic Medical Center of Chinese People’s Armed Police Force, Tianjin 300162, China; 2 Sanitary Corps of Jiayuguan Detachment, Chinese People’s Armed Police Force
  • Received:2019-02-26 Revised:2019-07-18 Published:2019-11-15 Online:2019-12-17

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摘要： 目的 观察单核巨噬细胞亚群在结缔组织病相关间质性肺病（CTD-ILD）患者中的表达情况。方法 选取2017年 7月—2018年 2月于中国人民武装警察部队特色医学中心住院的 CTD患者 77例作为研究对象，根据是否合并ILD分为CTD合并ILD组（CTD-ILD组）47例和单纯CTD组（CTD-nILD组）30例。收集患者一般资料、肺功能检查及胸部HRCT等资料。（1）选取同时期健康体检者30例作为健康对照组（NC组），流式细胞术测定CTD-ILD组、CTDnILD组及NC组外周血单核细胞亚群的比例，比较各组单核细胞比例，并对单核细胞比例与HRCT评分、肺功能指标进行相关性分析。（2）将行支气管镜检查的 25例 CTD-ILD患者作为试验组，选取 20例胸部影像学正常的咳嗽或胸闷、需行支气管镜检查以明确诊断，且镜检未见明显异常、支气管肺泡灌洗液（BALF）细胞学常规检查无异常的患者作为对照组。流式细胞术检测试验组和对照组 BALF中巨噬细胞亚群比例，比较各组巨噬细胞比例，并对巨噬细胞比例与 HRCT 评分、肺功能指标进行相关性分析。结果 （1）CTD-ILD 组 Mon2 亚群比例（6.32%±2.60%）较 CTDnILD组（5.00%±1.52%）及NC组（3.65%±1.36%）均明显升高（P＜0.05），Mon2亚群比例与HRCT磨玻璃影评分呈正相关（r=0.372，P=0.010）；（2）试验组 M2亚群比例明显高于对照组（t=6.520，P＜0.001）。结论 CTD-ILD患者中 Mon2单核细胞、M2巨噬细胞明显升高，可能与ILD发生发展过程存在一定的联系。

关键词: 结缔组织病, 间质性肺病, 单核细胞, 巨噬细胞, 流式细胞术

Abstract: Objective To observe the level of monocyte/macrophage subsets in patients with connective tissue diseases associated interstitial lung disease (CTD-ILD). Methods A total of 77 CTD patients hospitalized at department of respiratory and critical care medicine in Characteristic Medical Center of Chinese People's Armed Police Force from July 2017 to February 2018 were recruited. The patients were divided into the CTD-ILD group (n=47) and the CTD-nILD group(n=30) according to whether CTD combined with ILD. The general information, pulmonary function tests and HRCT data were collected in the two groups of patients. (1) Thirty cases with normal physical examination were recruited as healthy control group (NC group). The circulating monocytes subtypes were measured by flow cytometry. (2) Twenty-five patients in the CTD-ILD group who underwent bronchoscopy were selected as experimental group, and 20 patients (include cough and chest tightness) with normal chest imaging and bronchoscopy results were enrolled as control group. Macrophage subtypes of bronchoalveolar lavage fluid (BALF) were measured by flow cytometry. Results 1. The Mon2 circulating monocytes were significantly higher in the CTD-ILD group (6.32±2.60) than those in the CTD-nILD group (5.00±1.52) and NC group (3.65±1.36, P＜0.05). The proportion of Mon2 circulating monocytes was positively correlated with gross glass score (r=0.372, P= 0.010). 2. The proportion of M2 macrophage was significantly higher in CTD-ILD group than that of control group (t=-6.520,P＜0.001). Conclusion In the patients of CTD-ILD, the levels of Mon2 monocytes and M2 macrophages increase significantly, which might be closely related with the development of ILD.

Key words: connective tissue disease, interstitial lung disease, monocyte, macrophage, flow cytometry