T淋巴细胞亚群在重症肺炎患者中的水平变化及在疾病转归评估中的应用

Changes in the Levels of T Lymphocyte Subsets in Patients with Severe Pneumonia and Their Application in the Assessment of Disease Regression

目的探讨T淋巴细胞亚群在重症肺炎患者中的水平变化及在疾病转归评估中的应用价值。方法选取2020年12月至2022年1月项城市第一人民医院收治的112例重症肺炎患者作为研究组,另选同期127例健康体检者作为对照组,对比两组及不同预后者T淋巴细胞亚群水平,分析其在疾病转归中的预测价值。结果生存患者、对照组患者CD3^(+)、CD4^(+)、CD4^(+)/CD8^(+)水平高于病死患者、研究组患者,CD8^(+)、CD19^(+)、CD16^(+)56^(+)水平低于病死患者、研究组患者(P<0.05)。经logistic回归模型分析,CD3^(+)<69.77%、CD4^(+)<29.12%、CD8^(+)>30.58%、CD19^(+)>13.53%、CD16^(+)56^(+)>11.41%、CD4^(+)/CD8^(+)<0.96与重症肺炎患者疾病转归存在关联性(P<0.05)。受试者工作特征曲线结果显示,CD8^(+)、CD19^(+)、CD16^(+)56^(+)、CD3^(+)、CD4^(+)、CD4^(+)/CD8^(+)联合预测疾病转归的曲线下面积为0.820,敏感度为84.00%,特异度为91.95%,高于单一检测(P<0.05)。结论T淋巴细胞亚群水平与重症肺炎患者疾病转归存在关联性,且联合预测对疾病转归具有较高应用价值。

Objective To investigate the changes in the levels of T lymphocyte subsets in patients with severe pneumonia and their application value in the assessment of disease regression.Methods A total of 112 patients with severe pneumonia admitted to Xiangcheng First People’s Hospital from December 2020 and January 2022 were selected as the study group,and another 127 patients with healthy physical examination during the same period were selected as the control group.The levels of T lymphocyte subsets in the two groups and different prognoses were compared to analyze their predictive value in disease regression.Results CD3^(+),CD4^(+),CD4^(+)/CD8^(+)levels were higher in the surviving patients and control group than in the sick and dead patients and study group,and CD8^(+),CD19^(+),CD16^(+)56^(+)levels were lower than in the sick and dead patients and study group(P<0.05).By logistic regression model analysis,CD3^(+)<69.77%,CD4^(+)<29.12%,CD8^(+)>30.58%,CD19^(+)>13.53%,CD16^(+)56^(+)>11.41%and CD4^(+)/CD8^(+)<0.96 were associated with disease regression in patients with severe pneumonia(P<0.05).The receiver operating characteristic curve showed that the area under curve of CD8^(+),CD19^(+),CD16^(+)56^(+),CD3^(+),CD4^(+)and CD4^(+)/CD8^(+)combination predicted disease regression was 0.820,the sensitivity was 84.00%,and the specificity was 91.95%,which was higher than that of a single test(P<0.05).Conclusion There is a correlation between T lymphocyte subpopulation levels and disease regression in patients with severe pneumonia,and the combined prediction has a high application value for disease regression.