血清降钙素原、C反应蛋白及T淋巴细胞亚群在老年脑卒中相关性肺炎患者中的表达及其诊治意义

Expression and Clinical Significances of Serum Procalcitonin, C-Reactive Protein and T Lymphocyte Subsets in Elderly Patients with Stroke Associated Pneumonia

目的分析血清降钙素原(PCT)、C反应蛋白(CRP)、T淋巴细胞亚群在老年脑卒中相关性肺炎(SAP)患者中的表达及其诊治意义。方法对2016年8月至2017年8月医院收治的180例老年急性脑卒中患者进行观察,将其中90例老年SAP患者作为试验组,将另外90例未发生肺炎的老年急性脑卒中患者作为对照组;在入院时对两组进行血清PCT、CRP、T淋巴细胞亚群(CD8^+、CD4^+、CD3^+、CD4^+/CD8^+)水平测定,记录检测结果。结果试验组血清PCT、CRP、CD8^+、CD4^+/CD8^+水平高于对照组,CD4^+、CD3^+水平明显低于对照组,差异有统计学意义(P<0.05)。结论老年SAP患者发病后细胞免疫功能减低,炎症介质(PCT、CRP)明显增多,通过检测PCT、CRP、T淋巴细胞亚群水平可以为老年SAP的早期诊断、病情及预后评估、治疗方法选择提供依据。

Objective To analyze the expression levels of serum procalcitonin(PCT),C-reactive protein(CRP) and T lymphocyte subsets in elderly patients with stroke associated pneumonia(SAP) and the significance of diagnosis and treatment. Methods 180 elderly patients with acute cerebral apoplexy treated in this hospital from August 2016 to August 2017 were observed. 90 elderly patients with SAP were included into experimental group. The other 90 elderly patients with acute cerebral apoplexy without pneumonia were included into control group. The levels of serum PCT, CRP and T lymphocyte subsets(CD8^+, CD4^+, CD3^+, CD4^+/CD8^+) were measured in two groups of patients at the time of admission, and the results were recorded. Results The levels of serum PCT, CRP, CD8^+ and CD4^+/CD8^+ of the experimental group were higher than those of the control group, and the levels of CD4^+ and CD3^+ of the experimental group were significantly lower than those of the control group(P<0.05). Conclusion In elderly patients with SAP, the cellular immune function decreased, and inflammatory mediators(PCT and CRP) increased significantly. The levels of PCT,CRP and T lymphocyte subgroups can provide a basis for the early diagnosis of SAP, the evaluation of the condition and prognosis, and the choice of treatment methods.