非结核分枝杆菌肺病患者外周血T淋巴细胞亚群与营养状况相互关系的探讨

Relationship between peripheral blood T lymphocyte subsets and nutrition status of patients with nontuberculosis mycobacteria lung disease

目的:探讨外周血CD4+T淋巴细胞对非结核分枝杆菌(NTM)肺病患者营养状况的影响。方法:回顾性调查分析2008年1月至2012年12月期间在我院收治确诊的NTM肺病患者78例,分为细胞免疫功能低下组43例和正常组35例。探讨细胞免疫功能与营养指标相关性。结果:外周血CD4+与CD3+、CD8+T淋巴细胞、CD4+/CD8+T淋巴细胞比值(2.03±0.87)呈正相关(P<0.05)。与ALB、PA无相关性(P>0.05)。细胞免疫功能低下组外周血淋巴细胞(TLC)计数明显低于对照组,合并支气管扩张例数明显高于对照组,差异有统计学意义(P<0.05)。结论:NTM患者多伴有营养不良,细胞免疫功能低下的NTM患者合并支气管扩张多见,TLC减少明显,但CD4+T淋巴细胞与血清蛋白质(ALB+PA)水平无必然相关性,NTM患者病变的严重程度是基础病变与细胞免疫、营养和感染等因素的共同结果。

Objective To explore the impact of peripheral blood CD4＋ T cells on nutritional status of patients with non-tuberculosis mycobacteria （NTM） lung disease. Methods A retrospective analysis was performed including 78 patients with NTM lung disease from January 2008 to December 2012 in Guangzhou Chest Hospital, who were divided into cellular immunocompromised group with 43 cases and control group including 35 cases and then the impact of malnutrition on cellular immune function decline was explored. Results Peripheral blood CD4＋ T cells were positively correlated with CD3＋ T cells, CD8＋ T cells, CD4＋/CD8＋ T cell ratio in all of the included patients （P 〈 0.05）, while there was no correlation among peripheral blood CD4＋ T cells, ALB and PA （P 〉 0.05 ）. Compared with those in control group, TLC count was obviously lower while there were more patients with bronchiectasis in cellular immunocompromised group, which indicated statistical significance （P 〈 0.05）. Conclusions Most of NTM patients are associated with malnutrition and NTM patients of cellular immunocompromised are associated with bronchiectasis easily and obvious reducing of TLC, but CD4＋ T cells and serum proteins levels are not necessarily correlated. The severity of NTM is commonly caused by such factors as basic pathologic change, cellular immunization, nutrition and infection.