糖尿病肾病血液透析继发肺部感染患者免疫球蛋白及炎症因子和T细胞亚群水平

Immunoglobulins,inflammatory factors and T lymphocyte subsets of diabetic nephropathy and hemodialysis patients with secondary pulmonary infection

目的分析免疫球蛋白、降钙素原(PCT)、C-反应蛋白(CRP)和T细胞亚群在糖尿病肾病血液透析继发肺部感染患者中的水平变化特点。方法选取2021年3月-2023年2月太原市中心医院收治的102例接受血液透析的糖尿病肾病患者,根据患者血液透析后是否发生肺部感染,分为感染组45例和未感染组57例,分析肺部感染对患者免疫球蛋白及炎症因子和T细胞亚群水平的影响。结果感染组患者外周血CD_(3)^(+)、CD_(4)^(+)表达水平(70.63±14.02)%、(38.50±9.15)%和CD_(4)^(+)/CD_(8)^(+)(1.47±0.27)水平高于未感染组(P<0.05),CD_(8)^(+)表达水平比较差异无统计学意义;感染组患者血清免疫球蛋白G(IgG)、IgA、IgM水平高于未感染组(P<0.05);感染组患者血清PCT、CRP水平高于未感染组(P<0.05)。结论糖尿病肾病血液透析继发肺部感染患者免疫功能较差、炎症反应明显。临床上可根据免疫球蛋白、PCT、CRP和T细胞亚群水平变化监测患者病情。

OBJECTIVE To observe the changes of levels of immunoglobulins,procalcitonin(PCT),C-reactive protein(CRP)and T lymphocytes subsets in the diabetic nephropathy(DN)and hemodialysis patients with secondary pulmonary infection.METHODS A total of 102 DN patients who received hemodialysis in Taiyuan Central Hospital from Mar 2021 to Feb 2023 were enrolled in the study and were divided into the infection group with 45 cases and the no infection group with 57 cases according to the status of pulmonary infection after the hemodialysis.The influence of pulmonary infection on the levels of immunoglobulins,inflammatory factors and T lymphocyte subsets was observed.RESULTS The expression levels of peripheral blood CD_(3)^(+),CD_(4)^(+)and CD_(4)^(+)/CD_(8)^(+)were respectively(70.63±14.02)%,(38.50±9.15)%and(1.47±0.27)higher in the infection group than in the no infection group(P<0.05),and there was no significant difference in the expression level of CD_(8)^(+)between the two groups.The levels of serum immunoglobulin G(IgG),IgA and IgM of the infection group were higher than those of the no infection group(P<0.05).The levels of serum PCT and CRP of the infection group were higher than those of the no infection group(P<0.05).CONCLUSION The DN and hemodialysis patients with secondary pulmonary infection show the poor immune function and significant inflammatory response.It is necessary for the hospital to monitor the illness condition based on the changes of levels of immunoglobulins,PCT,CRP and T lymphocyte subsets.