老年感染性发热与免疫功能的关系研究

Study on the Association between Immunological Function and Fever Caused by Infectious Diseases in the Aged Patients

目的了解老年感染性发热患者的常见发热原因及其T淋巴细胞亚群、免疫球蛋白的变化情况,分析老年感染性发热与其免疫功能的相关性。方法对2006-2009年我院感染科收治的100例感染性发热的老年住院患者的病因及病原微生物进行分析,应用流式细胞术检测患者外周血T淋巴细胞亚群,采用免疫比浊法检测免疫球蛋白IgA、IgG、IgM,并与40名健康体检老年人及40名健康体检年轻人对照。结果老年感染性发热最常见的原因为肺部感染、尿路感染、胆道感染等,以细菌性感染最多见。健康老年人较健康年轻人CD3+、CD4+明显下降。感染性发热老年组CD3+、CD4+、CD4+/CD8+较健康年轻组明显下降,而IgM、IgG高于健康年轻组;IgA、IgM、IgG、CD8+水平显著高于健康老年组。结论老年感染性发热的病因以细菌性感染为主,老年感染性发热与其免疫功能紊乱相关,表现为T细胞免疫功能低下及调节网络平衡失调,体液免疫紊乱,故感染性发热老年患者在抗感染的同时应注意调节患者的免疫功能。

Objective To explore the relationship between fever caused by infectious diseases and immune function in the elder patients.Methods Data were retrospectively collected from the aged patients with fever caused by infectious diseases hospitalized in the department of infectious disease from May 2006 to May 2009.Serum levels of T cell subsets and immunoglobulin including IgA,IgG and IgM were measured both in the 100 cases and the 80 controls（40 healthy old people and 40 healthy young people）by flow cytometry and immunity transmission turbidimetry technique.Results The most common reason for infectious diseases in the aged patients was bacterial infection such as respiratory infection,urinary tract infection and biliary tract infection.The levels of CD3^＋cell and CD4^＋ cell in the aged control group were significantly lower than those in the young control group.Compared with the young control group,levels of CD3^＋cell,CD4^＋cell and CD4^＋/CD8^＋ in the aged patients with fever caused by infectious diseases were significantly lower while levels of IgM and IgG were significantly higher.Compared to those in the aged control group,levels of IgA,IgM,IgG and CD8^＋ cell in the cases were significantly higher.Conclusion The most common cause of infectious disease in the aged patients is bacterial infection.The occurrence of fever caused by infectious diseases in the aged patients is related to the immunological dysfunction.Therefore,it is important to pay attention to the immunological function maintenance in the anti-infection treatment of the aged patients.