老年重症肺炎患者血磷与免疫状态相关性研究

Observation of Relationship between Serum Phosphorus and Immunological State of Severe Pneumonia in Elderly Patient

探讨老年重症肺炎患者的血清无机磷水平和免疫功能状态的相关性。方法:选取42例伴有低磷血症和43例非低磷血症的老年重症肺炎患者,并随机选取30例健康体检老年人,检测其血清中无机磷含量,并利用流式细胞术检测其外周血淋巴细胞亚群百分比及绝对值。结果:低磷血症组CD4 +%和CD4 +/CD8 +显著低于非低磷血症组和正常对照组,而非低磷血症组和正常对照组比较,差异无统计学意义。3组之间CD3 +和CD4 +细胞绝对值比较,差异有统计学意义。重症肺炎患者无论磷高低与否CD8 +、B细胞和NK细胞绝对值均显著低于正常对照组。老年重症肺炎患者的血磷水平和CD4 +/CD8 +比值具有显著相关性( P =0.000),相关系数为0.626。结论:与健康同龄人比较,老年重症肺炎患者免疫功能显著降低,同时伴有低磷血症的患者免疫功能更加低下,且普遍处于免疫抑制状态。老年重症肺炎患者的血清磷与其CD4 +/CD8 +比值呈正相关。

To observe the relationship between serum phosphorus and immunological function of severe pneumonia in elderly patient. Methods We collected two samples from respiration medicine.In group A,there were 42 cases which belongs to eldly patient with severe pneumonia and hypophosphatemia. In group B,there were 43 cases which belongs to eldly patient with severe pneumonia but without hypophosphatemia. Besides, 30 cases of healthy old men were as controls.We measured serum phosphorus levels and lymphocyte subsets of each case. Results The percentages of CD4 +% and CD4 +/CD8 + in hypophosphatemia group were significantly lower than those in non-hypophosphatemia group and normal control group, but there was no significant difference between non-hypophosphatemia group and normal control group. The absolute values of CD3 + and CD4 + cells among the three groups all had significant differences. The absolute value of CD8 +, B cells and NK cells in patients with severe pneumonia was significantly lower than that in the control group, regardless of phosphorus level or not. There was a correlation between serum phosphorus and the ratio of CD4 + to CD8 +.The correlation coefficient is 0.626( P =0.000). Conclusion (1)Compared with healthy people, the eldly patient in severe pneumonia had impaired immunity,and those who were in hypophosphatemia meanwhile were ketp in an immunesuppressve state.(2)Positive correlation was found between the ratio of CD4 + to CD8 + and serum phosphorus of the eldly patient with severe pneumonia.