老年SAP患者外周血T淋巴细胞亚群、血清PCT及hs-CRP水平变化的临床探析

Clinical Analysis of Changes of Peripheral Blood T-lymphocyte Subsets,Serum PCT and Hs-CRP Levels in Elderly Patients with SAP

目的探讨老年卒中相关性肺炎(SAP)患者外周血T淋巴细胞亚群、血清降钙素原(PCT)和高敏-C反应蛋白(hs-CRP)水平变化。方法将2017年2月～2018年2月本院收治的24h内发病入院的老年卒中患者59例作为观察组,1周内发生SAP的患者35例纳入A组,未发生SAP的患者24例纳入B组;再将同期来本院进行健康体检者45例作为对照组。检测各组外周血T淋巴细胞亚群、血清PCT和hs-CRP水平,并进行对比分析。结果 A、B组CD3^+、CD4^+、CD4^+/CD8^+水平均低于对照组,CD8^+水平高于对照组,差异有统计学意义(P <0.05);A组CD4^+/CD8^+水平低于B组,差异有统计学意义(P<0.05);A、B组血清PCT、hs-CRP水平均高于对照组,差异有统计学意义(P <0.05);A组血清PCT、hs-CRP水平均高于B组,差异有统计学意义(P <0.05)。结论老年SAP患者发病初期细胞免疫功能水平较低,血清PCT、hs-CRP水平较高,血清PCT和hs-CRP对于检验早期卒中相关性肺炎具有显著临床价值。

Objective To investigate the changes of peripheral blood T-lymphocyte subsets, serum procalcitonin (PCT) and high-sensitivity-C-reactive protein (hs-CRP) levels in elderly patients with stroke-associated pneumonia (SAP). Methods Fifty-nine patients with senile stroke admitted to hospital within 24 hours from February 2017 to February 2018 in our hospital were selected as study subjects. 35 patients with SAP within 1 week were included in group A, and 24 patients without SAP were included in group B in this study;45 cases of physical examination in our hospital at the same period were used as control group. Peripheral blood T lymphocyte subsets, serum PCT and hs-CRP levels were measured and compared. Results The levels of CD^3+, CD^4+, and CD^4+/CD^8+ in group A and B were lower than those in control group. The level of CD^8+ was higher than that in control group (P <0.05). The ratio of CD^4+/CD^8+ in group A was lower than that in group B (P <0.05);Serum PCT and hs-CRP levels in group A and B were significantly higher than those in control group (P <0.05);Serum PCT and hs-CRP levels were higher in group A than in group B, the difference was statistically significant (P <0.05). Conclusions The elderly patients with SAP have lower levels of cellular immune function at the early onset, and serum PCT and hs-CRP levels are higher. Serum PCT and hs-CRP show significant clinical value for the detection of early strokeassociated pneumonia.