淋巴细胞计数对老年社区获得性肺炎患者预后的预测价值

Prognostic value of lymphocyte count in elderly patients with acquired pneumonia

目的探讨血常规中淋巴细胞计数对老年社区获得性肺炎患者疗效的预测价值。方法选取2016年3月至2017年9月本院呼吸科240例社区获得性肺炎(community-acquired pneumonia,CAP)患者,采集患者入院时静脉血进行血常规分析,根据患者淋巴细胞计数将患者分为两组,淋巴细胞计数≥1.0×109/L为A组(n=110),<1.0×109/L为B组(n=130)。对比两组患者T淋巴细胞亚群水平、症状体征恢复时间、达出院标准时间。结果 A组CD4+、CD4+/CD8+均明显高于B组,CD8+低于B组,差异有统计学意义(P<0.05)。A组总有效率为98.2%,高于B组的总有效率86.2%,差异有统计学意义(P<0.05)。A组咳嗽消失时间、啰音消失时间及达出院标准时间均短于B组(P<0.05)。结论血常规中淋巴细胞计数可评估老年社区获得性肺炎患者预后,有助于临床医生提前识别预后较差的患者,及早做出相应处理,值得临床推广应用。

Objective To explore the predictive value of lymphocyte count in blood routine in elderly patients with community-acquired pneumonia.Methods From March2016to September2017,240cases of community-acquired pneumonia.Venous blood was collected on admission for routine analysis,then patients were divided into two groups according to their lymphocyte count,which A group with110patients who lymphocyte counts are greater than or equal to1.0×10^9/L,and B group with130patients who lymphocyte counts are less than1.0×10^9/L.The T-lymphocyte subset(CD4^+、CD8^+、CD4^+/CD8^+),recovery time for symptoms and signs,days of reaching discharged standard between the two groups were compared.Results The CD4^+、CD4^+/CD8^+in A group were higher than that in B group,while the CD8+was lower(P<0.05).The effective rate in A group was98.2%,which higher than that in B group with86.2%(P<0.05).The disappearing time of cough and rales,discharging standard in A group were significantly shorter than those in B group(P<0.05).Conclusion Lymphocyte count in blood routine can be used to evaluate the prognosis of elderly patients with community-acquired pneumonia,which is helpful for clinicians to identify patients with poor prognosis in advance and make corresponding treatments as soon as possible,and it is worth popularizing and applying.