淋巴细胞亚群与病毒性肺炎合并ARDS预后的关系

Relationship between lymphocyte subsets and prognosis of patients with viral pneumonia complicated with ARDS

目的:探讨中性粒细胞淋巴细胞比值(NLR)、IL-6及淋巴细胞亚群与病毒性肺炎合并急性呼吸窘迫综合征(ARDS)患者预后的相关性。方法:选取2017年5月至2019年6月进入新乡市中心医院/新乡医学院第四临床学院进行治疗的病毒性肺炎合并ARDS患者98例,分析NLR、IL-6及淋巴细胞亚群在不同严重程度患者中的表达,Pearson相关性分析检测NLR、IL-6及淋巴细胞亚群水平与病毒性肺炎合并ARDS预后的相关性,Logistc回归分析检测病毒性肺炎合并ARDS预后的危险因素。结果:随着病毒性肺炎合并ARDS病情程度加重,NLR、IL-6水平明显上升(P<0.05),CD3^(+)T、CD4^(+)T及CD19^(+)T细胞水平明显降低(P<0.05)。Pearson相关性分析结果显示,NLR、IL-6与病毒性肺炎合并ARDS预后呈正相关(P<0.05),CD3^(+)T、CD4^(+)T、CD19^(+)T及CD8^(+)T细胞与病毒性肺炎合并ARDS预后呈负相关(P<0.05)。多因素Logistic分析结果显示,NLR、IL-6、CD3^(+)T及CD19^(+)T细胞为病毒性肺炎合并ARDS预后的危险因素(P<0.05)。结论:血清NLR、IL-6、CD3^(+)T及CD19^(+)T细胞与病毒性肺炎合并ARDS患者严重程度及预后密切相关。

Objective:To investigate correlation between neutrophil lymphocyte ratio(NLR),IL-6 and lymphocyte subsets and prognosis of viral pneumonia complicated with acute respiratory distress syndrome(ARDS).Methods:A total of 98 patients with viral pneumonia complicated with ARDS admitted to Xinxiang Central Hospital/the Fourth Clinical College from May 2017 to June 2019 were selected,NLR,IL-6 and lymphocyte subsets expressions in patients with different severity were analyzed.Correlation between NLR,IL-6 and lymphocyte subsets levels in prognosis of viral pneumonia complicated with ARDS was analyzed by Pearson correlation.Logistc regression was used to analyze prognostic risk factors of viral pneumonia complicated with ARDS.Results:With aggravation of viral pneumonia complicated with ARDS,NLR and IL-6 levels were significantly increased(P<0.05),while CD3^(+)T,CD4^(+)T and CD19^(+)T cells levels were significantly decreased(P<0.05).Pearson correlation analysis results showed that NLR and IL-6 were positively correlated with prognosis of viral pneumonia complicated with ARDS(P<0.05),while CD3^(+)T,CD4^(+)T,CD19^(+)T and CD8^(+)T cells were negatively correlated with prognosis of ARDS with viral pneumonia(P<0.05).Multivariate Logistic analysis showed that NLR,IL-6,CD3^(+)T and CD19^(+)T cells were risk factors for viral pneumonia complicated with ARDS(P<0.05).Conclusion:Serum NLR,IL-6,CD3^(+)T and CD19^(+)T cells are closely related to severity and prognosis of patients with viral pneumonia complicated with ARDS.