急性脑梗死患者红细胞免疫、细胞免疫的变化及与肺部感染的关系探究

Investigation on the Change of Erythrocyte Immunity and Cellular Immunity of Patients with Acute Cerebral Infarction and Its Correlation with Pulmonary Infection

目的:探究急性脑梗死患者红细胞免疫、细胞免疫的变化及与肺部感染的关系。方法:选取2019年10月-2021年12月福建医科大学附属漳州市医院收治的50例急性脑梗死合并肺部感染患者为A组,另选取本院50例无肺部感染的急性脑梗死患者为B组、50名健康者为C组。回顾性分析三组的红细胞免疫指标[红细胞免疫黏附促进率(RFER)、红细胞免疫黏附抑制率(RFIR)、C3b受体花环率(RBC-C3bRR)及红细胞免疫复合物花环率(RBC-ICR)]、细胞免疫指标(CD3^(+)、CD4^(+)及CD8^(+))及炎症反应指标[白细胞(WBC)、C反应蛋白(CRP)及降钙素原(PCT)],采用Pearson相关性分析上述红细胞免疫及细胞免疫指标与急性脑梗死肺部感染患者的临床肺部感染评分(CPIS)、炎症反应指标的关系。结果:A组的RFIR、RBC-ICR、CD8^(+)及炎症反应指标显著高于B、C组,且B组显著高于C组,差异有统计学意义(P<0.05);A组的RFER、RBC-C3bRR及CD3^(+)、CD4^(+)显著低于B、C组,B组则显著低于C组,差异有统计学意义(P<0.05);Pearson相关性分析显示,RFIR、RBC-ICR及CD8^(+)与急性脑梗死肺部感染患者的炎症反应指标及CPIS呈正相关(P<0.05),RFER、RBC-C3bRR及CD3^(+)、CD4^(+)与急性脑梗死肺部感染患者的炎症反应指标及CPIS呈负相关(P<0.05)。结论:急性脑梗死肺部感染患者红细胞免疫、细胞免疫状态显著异常,且上述指标与CPIS及炎症反应指标有密切的关系,在急性脑梗死肺部感染防控与诊治中的参考价值较高。

Objective:To investigate the change of erythrocyte immunity and cellular immunity of patients with acute cerebral infarction and its correlation with pulmonary infection.Method:A total of 50 patients with acute cerebral infarction complicated with pulmonary infection admitted to Zhangzhou Hospital Affiliated to Fujian Medical University from October 2019 to December 2021 were chosen as the group A,other 50 patients with acute cerebral infarction and without pulmonary infection in our hospital were chosen as group B,a total of 50 healthy people were chosen as group C.The erythrocyte immunity indexes[rosette forming enhancing rate of erythrocyte receptor (RFER),rosette forming inhibitory rate of erythrocyte receptor (RFIR),red blood cell C3b receptor rosette rate (RBC-C3bRR) and red blood cell immune complex rosette rate (RBC-ICR)],cellular immunity indexes (CD3^(+),CD4^(+)and CD8^(+)) and inflammatory response indexes[white blood cell (WBC),C-reactive protein (CRP) and procalcitonin (PCT)]were analyzed restrospectively.Then the correlation between those erythrocyte immunity,cellular immunity indexes and clinical pulmonary infection score (CPIS),inflammatory response indexes of patients with acute cerebral infarction complicated with pulmonary infection were analyzed with Pearson correlation analysis.Result:The RFIR,RBC-ICR,CD8^(+)and inflammatory response indexes in the group A were significantly higher than those in the group B and C,and the group B were significantly higher than that in the group C,the differences were statistically significant (P<0.05).The RFER,RBC-C3bRR and CD3^(+),CD4^(+)in the group A were significantly lower than those in the group B and C,and the group B were significantly lower than that in the group C,the differences were statistically significant (P<0.05).The Pearson correlation analysis showed the RFIR,RBC-ICR and CD8^(+)were positively correlated with CPIS and inflammatory response indexes of patients with acute cerebral infarction (P<0.05),the RFER,RBC-C3bRR and CD3^(+),CD4^(+)were negatively correlated with CPIS and inflammatory response indexes of patients with acute cerebral infarction (P<0.05).Conclusion:The erythrocyte immunity and cellular immunity of patients with acute cerebral infarction complicated with pulmonary infection are significantly abnormal,and they have close relationship with the CPIS and inflammatory response indexes,so their reference value in the prevention and treatment of pulmonary infection in acute cerebral infarction are high.