CRP、TNF-α、PCT及T淋巴细胞亚群在老年哮喘急性发作期中的应用价值分析

An analysis on the application value of CRP,TNF-α,PCT and T lymphocyte subsets examination for the elderly patients with acute asthma attack

目的探讨CRP、TNF-α、PCT及T淋巴细胞亚群在老年哮喘急性发作期中的应用价值。方法选取80例老年哮喘急性发作患者作为研究对象,根据合并感染情况分为细菌感染组、病毒感染组和单纯发作组,分别纳入患者39例、26例和15例,对三组患者的T淋巴细胞亚群、血清C反应蛋白(CRP)、肿瘤坏死因子α(TNF-α)、降钙素原(PCT)水平进行检测和分析。结果细菌感染组患者血清CRP和TNF-α水平显著高于病毒感染组(P<0.05),病毒感染组显著高于单纯发作组(P<0.05);细菌感染组患者的血清PCT水平显著高于病毒感染组和单纯发作组(P<0.05),而病毒感染组和单纯发作组之间无显著性差异(P>0.05);在T淋巴细胞亚群中,细菌感染组患者的CD3+细胞比例显著高于单纯发作组和病毒感染组(P<0.05),单纯发作组与病毒感染组之间的差异无显著性(P>0.05);细菌感染组患者的CD4+细胞比例和CD4+/CD8+细胞比值均显著高于单纯发作组(P<0.05),单纯发作组均显著高于病毒感染组(P<0.05);病毒感染组患者的CD8+细胞比例显著高于单纯发作组和细菌感染组(P<0.05),单纯发作组与细菌感染组之间的差异无显著性(P>0.05)。结论在老年哮喘急性发作时,CRP、TNF-α水平对细菌和病毒感染反应较敏感,而PCT水平则对病毒感染无显著反应,合并细菌感染患者的T淋巴细胞亚群检测结果呈现免疫反应增强,而合并病毒感染患者则呈现免疫反应抑制,临床医生应根据这些指标进行鉴别诊断以制定合理的治疗方案。

Objective To observe and analyze the application value of CRP,TNF-a,PCT and T lymphocyte subsets examination for the elderly patients with acute asthma attack. Methods 80 cases of elderly patients with acute asthma attack were selected as the research objects and divided into the bacterial infection group,the virus infection group and the simple attack group according to the infection conditions. 39 patients,26 cases and 15 cases were included into each groups. T lymphocyte subsets, serum C reactive protein in patients （CRP）, tumor necrosis factor alpha （TNF- a）, pro- calcitonin （PCT） levels of the patients inthree groups were detected and analyzed. Results The serum CRP and TNF- levels of the bacterial infection group were significantly higher than those of the virus infection group （P〈0.05）, the levels of the viral infection group were significantly higher than those of the simple attack group （P〈0.05） ;the serum PCT level of the bacterial infection group was significantly higher than that of the virus infection group and the simple attack group （P〈0.05） and the difference between the virus infection group and the simple attack group was not sig- nificant （P〉0.05） ;the T lymphocyte subsets examination showed CD3＋ cell ratio Of the patients in the bacterial infec- tion group was significantly higher than that in the simple attack group and the virus infection group （P〈0. 05） ,the differences between the simple attack group and the virus infection group was not significant（P〈0. 05） ;the CD4＋ cell ratio and the CD4＋/CD8＋ cell ratio of the patients in the bacterial infection group were higher than those of the simple attack group （P〈0.05） ,the ratios of the simple attack group were significantly higher than those of the virus infection group （P〈0.05） ;the CD8＋ cell ratio of the patients in the virus infection group was significantly higher than that in the simple attack group and the bacterial infection group （P〈0.05）, the difference between the simple attack group and the bacterial infection group was not significant （P〉0.05）. Conclusion For the elderly patients with acute asthma at- tack, reflections of serum CRP,TNF-a levels to the bacterial and virus infections are sensitive, while the PCT level does not significantly response to the virus infection. The T lymphocyte subsets examination shows an enhanced immune re- sponse of the patients with acute asthma attack combined with bacterial infection, while an inhibited immune response of the patients with acute asthma attack combined with virus infection. The clinicians should perform a differential diagno- sis based on these indicators to make a suitable treatment plan.