矽肺患者反复呼吸道感染与免疫功能关系的临床研究

Relationship between Immune Function and Recurrent Respiratory Tract Infection in Pneumosilicosis Patients

目的探讨矽肺患者反复呼吸道感染与免疫功能的关系。方法选择2009年5月—2010年5月在台州市立医院、温州医学院第一附属医院和金华市人民医院呼吸科门诊随诊的老年矽肺患者为研究对象。根据随访期间发生呼吸道感染的次数,分为矽肺伴反复感染组和矽肺不伴反复感染组,并将同期体检的健康人群作为对照,比较三组外周血T淋巴细胞亚群(CD4+%、CD8+%、CD4+/CD8+)和免疫球蛋白(IgA、IgM、IgG)的差异,并进行多因素Logistic回归分析,探讨矽肺患者反复呼吸道感染的危险因素。结果 (1)反复感染组IgA、IgM、IgG、CD4+%、CD8+%和CD4+/CD8+均低于非反复感染组,差异均有统计学意义(P<0.05);IgA、IgM、IgG、CD4+%、CD8+%和CD4+/CD8+在三组间比较,差异均有统计学意义(P<0.05)。(2)多因素Logistic回归分析显示,IgA每降低1单位,反复呼吸道感染概率增加18.7%;CD4+/CD8+每降低1单位,反复呼吸道感染概率增加15.5%。结论免疫功能低下是矽肺患者反复呼吸道感染的重要原因。低IgA和低CD4+/CD8+比值是矽肺患者反复呼吸道感染的独立危险因素。

Objective To explore the relationship between immune function and recurrent respiratory tract infection （RRTI） in patients with pneumnsilicnsis. Methods A total of 172 pneumnsilicosis patients, recruited from May 2009 to May 2010 from our three hospitals, were divided as recurrent infection group and non - recurrent infection group according to their frequency of respiratory tract infection during the follow - up period, with 86 in each group. And 86 healthy persons were recruited as controls. The differences of the peripheral blood T lymphocyte subsets and immunoglobulin were compared among the three groups by using Logistic regression analysis. Results （ 1 ） The concentrations of IgA, IgM, IgG, CD4^＋%, CD8 ＊^%＋ and CD4^＋/CD8^＋ were significantly lower in the recurrent infection group than those in the non - recurrent infection group （ P 〈 0. 05）. There were significant differences in IgA, IgM, IgG, CD4 ^＋ % , CD8 ^＋ % and CD4^＋/CD8^＋ among the three groups （P 〈 0. 05 ）. （ 2 ） The multivariate Logistic regression analysis showed that each unit decreased in the concentration of IgA and CD4 ^＋/CD8^＋ could increase the risk of RRTI respectively by 18.7% and 15.5%. Conclusion Decreased immune function is an important cause for RRTI in pneumnsilicnsis patients, and low concentration of IRA and low ratio of CD4 ^＋/CD8 ^＋ were the independent risk factors.