Clinical study on the differential expression of immune markers in peripheral blood and sputum of elderly patients with chronic obstructive pulmonary disease (COPD) infected with influenza in Liaoning Province
辽宁老年慢阻肺患者流感感染外周血与痰液免疫标志物表达差异的临床研究

摘要

目的 探究辽宁工业区老年慢性阻塞性肺疾病（COPD）患者流感感染后外周血、痰液免疫标志物表达的特征差异。方法 选择锦州医科大学附属第一医院呼吸科/老年科就诊的70例稳定期COPD患者（2025年10月-2026年3月）作为稳定期COPD组，另选择同期本院就诊的70例COPD合并流感患者作为COPD合并流感组。统计两组流式细胞检测结果，计算并对比两组外周血CD8⁺T细胞耗竭指数，同时对比外周血与痰液免疫标志物表达差异。结果 稳定COPD组CD8⁺T细胞耗竭指数显著低于COPD合并流感组（P＜0.001）。两组患者痰液标本中白介素‑6（IL-6）、C-X-C基序趋化因子配体10（CXCL10）、肺表面活性物质蛋白D（SP-D）水平显著高于外周血清（P＜0.001）；与同组血清标本比较，两组痰液标本中sIgA水平相对较高（P＜0.001）。COPD合并流感组痰液标本中sIgA显著低于稳定期COPD组（P＜0.001）。COPD合并流感组痰液标本中CXCL10、IL-6、SP-D水平显著高于稳定期COPD组（P＜0.001）。结论 合并流感感染患者存在CD8⁺T细胞耗竭指数升高表现，且痰液免疫标志物较外周血变化幅度更大。

Abstract

Objective To investigate the differential expression of immune markers in peripheral blood and sputum of elderly patients with chronic obstructive pulmonary disease (COPD) in Liaoning industrial zone after influenza infection.
Methods 70 stable COPD patients (October 2025 March 2026) who visited the Respiratory Department/Geriatric Department of the First Affiliated Hospital of Jinzhou Medical University were selected as the stable COPD group, and another 70 COPD patients with influenza who visited our hospital during the same period were selected as the COPD with influenza group. Statistically analyze the results of two sets of flow cytometry tests, calculate and compare the exhaustion index of CD8+ T cells in peripheral blood between the two groups, and compare the differences in the expression of immune markers between peripheral blood and sputum.
Results The CD8+ T cell depletion index in the stable COPD group was significantly lower than that in the COPD combined with influenza group (P<0.001). The levels of Interleukin‑6 (IL‑6), C‑X‑C motif chemokine ligand 10 (CXCL10), surfactant protein D (SP‑D) in sputum samples of two groups of patients were significantly higher than those in peripheral serum (P<0.001); Compared with serum samples from the same group, the levels of sIgA in sputum samples from both groups were relatively high (P<0.001). The sIgA in sputum samples of COPD combined with influenza group was significantly lower than that of stable COPD group (P<0.001). The levels of CXCL10, IL-6, and SP-D in sputum samples from COPD combined with influenza were significantly higher than those in the stable COPD group (P<0.001).
Conclusion   Patients with combined influenza infection exhibit an increase in CD8+ T cell depletion index, and sputum immune markers show greater changes than peripheral blood.