支气管肺炎患儿血清LDH3及T细胞亚群水平变化及临床意义

Changes and clinical significance of serum LDH3 and T cell subsets in children with bronchopneumonia

目的:研究支气管肺炎患儿血清乳酸脱氢酶3(lactate dehydrogenase 3,LDH3)及T细胞亚群水平变化及临床意义。方法:选取2019年6月至2020年6月张家口市妇幼保健院收治的细菌性支气管肺炎患儿60例作为肺炎组,按照疾病严重程度分为轻症组26例、重症组34例,另取同期同年龄段体检健康的儿童30例作为健康组。对比健康组、轻症组与重症组治疗前血清LDH3及T细胞亚群水平、肺炎组治疗前、中、后血清LDH3及T细胞亚群水平、肺炎组治疗有效与无效患儿血清LDH3及T细胞亚群水平,并对血清LDH3、T细胞亚群水平与支气管肺炎严重程度、血清LDH3与T细胞亚群水平进行Pearson相关性分析。结果:轻症组与重症组血清LDH3、CD8^(+)水平明显高于健康组(P<0.05),CD3^(+)、CD4^(+)、CD4^(+)/CD8^(+)水平明显低于健康组(P<0.05),且重症组血清LDH3、CD8^(+)水平明显高于轻症组(P<0.05),CD3^(+)、CD4^(+)、CD4^(+)/CD8^(+)水平明显低于轻症组(P<0.05);治疗中及治疗后肺炎患儿血清LDH3、CD8^(+)水平明显低于治疗前(P<0.05),CD3^(+)、CD4^(+)、CD4^(+)/CD8^(+)水平明显高于治疗前(P<0.05),且治疗后血清LDH3、CD8^(+)水平明显低于治疗中(P<0.05),CD3^(+)、CD4^(+)、CD4^(+)/CD8^(+)水平明显高于治疗中(P<0.05);肺炎组治疗有效患儿血清LDH3、CD8^(+)水平明显低于无效患儿(P<0.05),CD3^(+)、CD4^(+)、CD4^(+)/CD8^(+)水平明显高于无效患儿(P<0.05);血清LDH3、CD8^(+)水平与支气管肺炎严重程度呈正相关(P<0.05),CD3^(+)、CD4^(+)、CD4^(+)/CD8^(+)水平与支气管肺炎严重程度呈负相关(P<0.05);血清LDH3水平与CD8^(+)水平呈正相关(P<0.05),与CD3^(+)、CD4^(+)、CD4^(+)/CD8^(+)水平呈负相关(P<0.05)。结论:血清LDH3及T细胞亚群水平与患儿细菌性支气管肺炎发生发展及转归密切相关,且病情越严重,血清LDH3、CD8^(+)水平越高,CD3^(+)、CD4^(+)、CD4^(+)/CD8^(+)水平越低。

Objective:To study the changes and clinical significance of serum lactate dehydrogenase 3(LDH3) and T cell subsets in children with bronchopneumonia.Methods:Sixty children with bacterial bronchopneumonia treated in our hospital from June 2019 to June 2020 were selected as a pneumonia group.They were divided into a mild group(n=26) and a severe group(n=34) according to the severity of the disease.Another 30 healthy children of the same age were selected as a healthy group.The levels of serum LDH3 and T cell subsets in the healthy group,the mild group and the severe group before treatment,the levels of serum LDH3 and T cell subsets in the pneumonia group before,during and after treatment,and the levels of serum LDH3 and T cell subsets in children with effective and ineffective treatment in the pneumonia group were compared.The levels of serum LDH3,T cell subsets and the severity of bronchopneumonia,serum LDH3 and T cell subsets were analyzed by Pearson analysis.Results:The serum levels of LDH3 and CD8^(+) in the mild group and severe group were significantly higher than those in the healthy group(P<0.05),while the levels of CD3^(+),CD4^(+) and CD4^(+)/CD8^(+) in the severe group were significantly lower than those in the healthy group(P<0.05).The serum levels of LDH3 and CD8^(+) in the severe group were significantly higher than those in the mild group(P<0.05),while the levels of CD3^(+),CD4^(+) and CD4^(+)/CD8^(+) in the severe group were significantly lower than those in the mild group(P<0.05).The serum levels of LDH3,CD8^(+),CD3^(+),CD4^(+) and CD4^(+)/CD8^(+) in children with pneumonia during and after treatment were significantly lower than those before treatment(P<0.05),and the levels of serum LDH3 and CD8^(+) after treatment were significantly lower than those during treatment(P<0.05),while the levels of CD3^(+),CD4^(+) and CD4^(+)/CD8^(+) were significantly higher than those before treatment(P<0.05).In pneumonia group,the levels of serum LDH3 and CD8^(+) were significantly lower than those of ineffective children(P<0.05),while the levels of CD3^(+),CD4^(+) and CD4^(+)/CD8^(+) were significantly higher than those of ineffective children(P<0.05).The levels of serum LDH3 and CD8^(+) were positively correlated with the severity of bronchopneumonia(P<0.05),while the levels of CD3^(+),CD4^(+) and CD4^(+)/CD8^(+) were negatively correlated with the severity of bronchopneumonia(P<0.05).The level of serum LDH3 was positively correlated with the level of CD8^(+),and negatively correlated with the levels of CD3^(+),CD4^(+) and CD4^(+)/CD8^(+)(P<0.05).Conclusion:The levels of serum LDH3 and T cell subsets are closely related to the occurrence,development and prognosis of bacterial bronchopneumonia.The more serious the disease is,the higher the serum levels of LDH3 and CD8^(+) are,and the lower the levels of CD3^(+),CD4^(+),and CD4^(+)/CD8^(+) are.