T淋巴细胞亚群在ARDS患者中的变化及意义

Changes and significance of T lymphocyte subsets in patients with ARDS

目的探讨T淋巴细胞亚群在急性呼吸窘迫综合征(ARDS)患者中的变化及意义。方法选取2016年3月至2018年6月北京市隆福医院(下称本院)收治的76例ARDS患者作为观察组,并选取50例体检健康者作为对照组,将ARDS患者按照病情严重程度分为轻度15例、中度39例、重度组22例,根据患者28 d预后情况将ARDS患者分为存活组54例与死亡组22例,采用流式细胞技术检测所有受试者的T淋巴细胞亚群(CD3+、CD4+、CD8+细胞),比较观察组和对照组、不同程度以及不同预后ARDS患者的CD3+、CD4+、CD8+细胞水平。结果观察组的CD3+、CD4+细胞水平明显低于对照组,差异有统计学意义(P<0.05),两组的CD8+细胞水平比较差异无统计学意义(P>0.05);不同程度ARDS患者的CD3+、CD4+、CD8+细胞水平比较差异具有统计学意义(P<0.05),轻度ARDS患者的上述指标水平最高,中度ARDS患者的上述指标水平次之,重度ARDS患者的上述指标水平最低;存活组的CD3+、CD4+、CD8+细胞水平明显高于死亡组,差异有统计学意义(P<0.05)。结论随着ARDS病情的不断发展,T淋巴细胞水平将随之降低,且T淋巴细胞亚群有助于评估ARDS病情严重程度。

Objective To investigate the changes and significance of T lymphocyte subsets in patients with acute respiratory distress syndrome(ARDS).Methods A total of 76 patients with ARDS admitted to Longfu Hospital of Beijing from March 2016 to June 2018 were selected as observation group,and 50 healthy persons were selected as control group during the same period.According to the severity of the disease,ARDS patients were divided into mild 15 cases,moderate 39 cases and severe 22 cases.According to the prognosis of 28 days,ARDS patients were divided into survival group(54 cases)and death group(22 cases).T lymphocyte subsets(CD3+,CD4+,CD8+cells)were detected by flow cytometry in all subjects.The levels of CD3+,CD4+,CD8+cells in ARDS patients with different degrees and prognosis were compared between the obsenation group and control group.Results The levels of CD3+,CD4+cells in the observation group were significantly lower than those in the control group(P<0.05),and there was no significant difference in the levels of CD8+cells between the two groups(P>0.05);the levels of CD3+,CD4+,CD8+cells in patients with different degrees of ARDS had significant difference(P<0.05).The above-mentioned indexes were the highest in mild ARDS patients,followed by moderate ARDS patients and the lowest in severe ARDS patients.The levels of CD3+,CD4+,CD8+cells in survival group were significantly higher than those in death group(P<0.05).Conclusion With the continuous development of ARDS,the level of T lymphocyte will decrease,and T lymphocyte subsets can help to assess the severity of ARDS.