老年重症肺炎患者免疫功能变化规律研究

Immune Function in Elderly Patients with Severe Pneumonia Variation

目的探索老年重症肺炎患者细胞免疫功能的变化规律。方法根据年龄及病情筛选肺炎患者并分成4组:老年重症组:老年重症肺炎患者50例;非老年重症组:非老年重症肺炎患者10例;老年非重症组:老年非重症患者28例;非老年非重症组:非老年非重症肺炎患者18例,运用流式细胞术对患者外周血进行T细胞亚群(CD3+、CD4+、CD8+、CD4+/CD8+)以及NK细胞活性进行检测。结果老年重症组患者在CD3+、CD4+、CD8+以及NK细胞活性方面与老年非重症组相比下降明显,P均<0.01;非老年重症组患者在CD3+、CD4+以及NK细胞活性方面均低于非老年非重症组患者,P<0.05或0.01;老年重症组患者在CD3+及CD8+两项指标上均低于非老年重症组患者,P均<0.05;老年非重症组与非老年重症组患者各项指标的比较不具有统计学意义,P均>0.05。结论重症肺炎患者较非重症肺炎患者在细胞免疫功能方面有所下降,且老年重症肺炎患者的免疫功能下降程度更为显著。机体免疫功能衰退可能是诱发老年患者重症肺炎的主要原因之一。

Objective Pneumonia in elderly patients with severe changes of immune function Methods Screening based on age and disease in patients with pneumonia,and divided into four groups：Aged patients with severe group： 50 cases of elderly patients with severe pneumonia;non-aged patients with severe group： non-elderly patients with severe pneumonia in 10 cases;elderly non-severe group： 28 cases of elderly patients with non-severe;non-elderly non-severe group： non-elderly patients with non-severe pneumonia in 18 cases;application of flow cytometry in peripheral blood T cell subsets（CD3＋,CD4＋,CD8＋,CD4＋/CD8＋） and NK cell activity.Results Elderly patients with severe CD3＋,CD4＋,CD8＋ and NK cell activity than elderly non-severe group was significantly decreased（Pall0.01）.Non-elderly patients with severe CD3＋,CD4＋ and NK cell activity were lower than non-elderly non-severe group（P0.05 or 0.01）.Elderly patients with severe CD3＋,CD8＋ were lower than non-senile severe group（P all 0.05）.Elderly non-severe group and non-elderly non-severe group,the indicators no significant difference（P all 0.05）.Conclusions Cellular immune function in patients with severe pneumonia than patients with non-severe pneumonia dropped,including severe pneumonia in elderly patients with decreased immune function is more evident.Decreased immune function in elderly patients may be one of the causes of severe pneumonia.