肺结核患者外周血CD4+T淋巴细胞水平的影响因素分析

Analysis of the Risk Factors of the Peripheral Blood CD4+T Lymphocyte Count of Pulmonary Tuberculosis Patients.

目的探索肺结核患者外周血CD4+T淋巴细胞水平的影响因素。方法采用回顾性分析纳入2019年1月1日至2020年6月30日在成都市公共卫生临床医疗中心结核科住院的肺结核患者429例,按外周血CD4+T淋巴细胞绝对计数分为两组:观察组CD4+T淋巴细胞<414个/μl患者210例;对照组CD4+T淋巴细胞≥414个/μl患者219例。提取两组患者的临床资料包括性别、年龄、治疗类型、合并其他呼吸系统疾病、合并糖尿病的情况,采用卡方检验比较两组患者的临床特征差异。将差异有统计学意义的临床特征纳入非条件二分类Logistic回归分析,探索肺结核患者外周血CD4+T淋巴细胞降低的独立影响因素。结果性别、年龄≥60岁、治疗类型、合并其他呼吸系统疾病、合并糖尿病在两组间的差异有统计学意义(P<0.05)。Logistic回归分析显示,肺结核患者外周血CD4+T淋巴细胞水平降低的独立危险因素是:年龄≥60岁(P<0.001,OR=2.325,95%CI=1.483~3.664)、合并其他呼吸系统疾病(P<0.001,OR=3.262,95%CI=1.777~5.986)、合并糖尿病(P=0.013,OR=2.437,95%CI=1.204~4.935)。结论老年、合并其他呼吸系统疾病、合并糖尿病是肺结核患者外周血CD4+T淋巴细胞水平降低的独立危险因素,临床上要关注这些患者的免疫状态。

Objective To explore the related factors of the peripheral blood CD4+T lymphocyte count of pulmonary tuberculosis patients.Methods To retrospectively analyze 429 cases of pulmonary tuberculosis patients who were admitted in Chengdu public health clinical centeRfrom January 1,2019 to June 30,2020,and were divided into two groups according to the peripheral blood CD4+T lymphocyte count:observation group(210 cases)with CD4+T lymphocytes count<414 cell/μl,and control group(219 cases)with CD4+T lymphocytes count≥414 cell/μl.Clinic characteristics(including gender,age,treatment type,respiratory complications,and diabetes mellitus)were collected,and Chi-square test was used to compare the differences between the two groups.The clinical characteristics with statistically significant differences were included in the logistic regression analysis to explore the independent influence factors of the peripheral blood CD4+T lymphocyte count in pulmonary tuberculosis patients.Results There were statistically significant differences in gender,age≥60 years old,treatment type,combination with otheRrespiratory diseases and combination with diabetes between the two groups(P<0.05).Logistic regression analysis showed that the independent risk factors affecting the peripheral blood CD4+T lymphocyte count of pulmonary tuberculosis patients were age≥60 years old(P<0.001,OR=2.325,95%CI=1.483~3.664),respiratory complications(P<0.001,OR=3.262,95%CI=1.777~5.986),and diabetes(P=0.013,OR=2.437,95%CI=1.204~4.935).Conclusion Agedness,combination with otheRrespiratory diseases and combination with diabetes are independent risk factors affecting the peripheral blood CD4+T lymphocytes count of pulmonary tuberculosis patients,and the immune status of these patients should be paid attention to in clinical work.