延缓吸收性肺炎免疫功能的变化及与血清铁蛋白的关系

Relationship between the changes of immunologic function and serum ferritin in patients with slowly resolving pneumonia

目的探讨延缓吸收性细菌性肺炎患者免疫功能及血清铁蛋白(SF)的关系。方法30例延缓吸收性细菌性肺炎患者为A组,30例常规吸收的社区获得性肺炎患者为B组及30例正常体检者为C组,分析3组研究对象的CD3+T细胞、CD4+T细胞、CD8+T细胞、NK细胞、B细胞的细胞比例、CD4+/CD8+T细胞比值和SF水平的变化。结果入院次日,A、B组患者CD3+T细胞、CD4+T细胞、NK细胞、B细胞比例均明显低于C组(P<0.01);A、B组CD8+T细胞的细胞比例、SF水平均比C组明显升高(P<0.01)。入院第14日A组患者CD3+T细胞、CD4+T细胞、NK细胞、B细胞的细胞比例均比B、C组明显下降(P<0.01);CD8+T细胞比例及SF水平比B、C组明显升高(P<0.01)。入院第28日3组受检者各指标比较差异均无统计学意义(P均>0.05)。A组患者SF水平与CD3+T细胞、CD4+T细胞、NK细胞、B细胞的细胞比例呈负相关(r分别为-0.472、-0.578、-0.602、-0.565、-0.587,P均<0.05),与CD8+T细胞水平呈正相关(r=0.542,P<0.05)。结论延缓吸收性肺炎患者存在不同程度的免疫功能紊乱,且与SF变化密切相关。

Objective To investigate the relationship between the changes of immunologic function and serum ferritin （SF）in patients with slowly resolving pneumonia. Mothods The data of 30 patients with slowly resolving pneumonia （group A）was analyzed and compared with 30 patients with normal resolving pneumonia （group B）and 30 normal people （group C）. The alternation of CD3 ＋T cell,CD4 ＋T cell,CD8 ＋T cell,CD4＋/CD8＋,NK cell and B cell and their relationship with SF were observed and analyzed. Results Compared with group C,percentage of CD3 ＋T cell,CD4 ＋T,NK cell and B cell significantly reduced in group A and B in the second day （P〈0.01 ）. Meanwhile,percentage of CD3 ＋T cell and SF level significant-ly increased in A and group B （P〈0.01 ）. In the 1 4th day,percentage of CD3 ＋T cell,CD4 ＋T cell,NK cell and B cell significantly reduced in group A compared with groupB and C （P〈0.01 ）. Percentage of CD8 ＋T cell and the SF level significantly increased in Group A （P〈0.01 ）. Indexes in three groups had no statistical significance in the 28th day （P〉0.05）. It showed negative correlation between SF levels and percentages of CD3 ＋T cells,CD4 ＋T cells,NK cells,B cells in group A （r=-0.472,-0.578,-0.602,-0.565,-0.587,P〈0.05）,and positive correlation between SF level and CD8 ＋T cells （r=0.542,P〈0.05）. Conclusion Disorder of immunologic situation exists in patients with slowly resolving pneumonia. Slowly resolving pneumo-nia is closely correlated with the SF level.