Peripheral T-lymphocyte subpopulations in different clinical stages of chronic HBV infection correlate with HBV load

AIM: To characterize the peripheral T-cell subpopulation profiles and their correlation with hepatitis B virus (HBV) replication in different clinical stages of chronic HBV infection.METHODS: A total of 422 patients with chronic HBV infection were enrolled in this study. The patients were divided into three stages: immune-tolerant stage, immune active stage, and immune-inactive carrier stage. Composition of peripheral T-cell subpopulations was determined by flow cytometry. HBV markers were detected by enzyme-linked immunosorbent assay. SerumHBV DNA load was assessed by quantitative real-time polymerase chain reaction.RESULTS: CD8+ T-cells were significantly higher in patients at the immune-tolerant stage than in patients at the immune-active and -inactive carrier stages (36.87 ± 7.58 vs 34.37 ± 9.07, 36.87 ± 7.58 vs 28.09 ± 5.64, P < 0.001). The peripheral blood in patients at the immune-tolerant and immune active stages contained more CD8+ T-cells than CD4+ T-cells (36.87 ± 7.58 vs 30.23 ± 6.35, 34.37 ± 9.07 vs 30.92 ± 7.40, P < 0.01), whereas the peripheral blood in patients at the immune-inactive carrier stage and in normal controls contained less CD8+ T-cells than CD4+ T-cells (28.09 ± 5.64 vs 36.85 ± 6.06, 24.02 ± 4.35 vs 38.94 ± 3.39, P < 0.01). ANOVA linear trend test showed that CD8+ T-cells were signif icantly increased in patients with a high viral load (39.41 ± 7.36, 33.83 ± 7.50, 31.81 ± 5.95 and 26.89 ± 5.71, P < 0.001), while CD4+ T-cells were signif icantly increased in patients with a low HBV DNA load (37.45 ± 6.14, 33.33 ± 5.61, 31.58 ± 6.99 and 27.56 ± 5.49, P < 0.001). Multiple regression analysis displayed that log copies of HBV DNA still maintained its highly signif icant coefficients for T-cell subpopulations, and was the strongest predictors for variations in CD3+, CD4+ and CD8+ cells and CD4+/CD8+ ratio after adjustment for age at HBV-infection, maternal HBV-infection status, presence of hepatitis B e antigen and HBV mutation.CONCLUSION: Differences in peripheral T-cell subpopulation profi les can be found in different clinical stages of chronic HBV infection. T-cell impairment is signifi cantly associated with HBV load.

Hypertonic saline resuscitation maintains a more balanced profile of T-lymphocyte subpopulations in a rat model of hemorrhagic shock

Objective: To investigate the potential and early effect of hypertonic saline resuscitation on T-lymphocyte sub- populations in rats with hemorrhagic shock. Methods: A model of rat with severe hemorrhagic shock was established in 18 Sprague-Dawley (SD) rats. The rats were randomly divided into Sham group, HTS group (hypertonic saline resuscitation group) and NS group (normal saline resuscitation group). Each group contained 6 rats. The CD4+ and CD8+ subpopulations of T-lymphocytes in peripheral blood were detected respectively before shock and after resuscitation by double antibody labelling and flow cytometry. Results: In the early stage after hemorrhagic shock, fluid resuscitation and emergency treatment, the CD4+ lymphocytes of peripheral blood in HTS and NS groups markedly increased. Small volume resuscitation with HTS also induced peripheral CD8+ lymphocytes to a certain extent, whereas NS resuscitation showed no effect in this respect. Consequently, compared with Sham and HTS groups, CD4+/CD8+ ratio of peripheral blood in NS group was obviously increased, and showed statistically differences. Conclusion: In this model of rat with severe hemorrhagic shock, small volume resuscitation with HTS is more effective than NS in reducing immunologic disorders and promoting a more balanced profile of T-lymphocyte subpopula- tions regulating network.

Hepatitis B virus DNA is more powerful than HBeAg in predicting peripheral T-lymphocyte subpopulations in chronic HBV-infected individuals with normal liver function tests

AIM:To investigate the peripheral T-lymphocyte subpopulation profile,and its correlations with hepatitis B virus(HBV) replication level in chronic HBV-infected(CHI) individuals with normal liver function tests(LFTs) . METHODS:Frequencies of T-lymphocyte subpopu-lations in peripheral blood were measured by flow cytometry in 216 CHI individuals. HBV markers were detected with ELISA. Serum HBV DNA load was assessed with quantitative real-time PCR. Information of age at HBV infection,and maternal HBV infection status was collected. ANOVA linear trend test and linear regression were used in statistical analysis. RESULTS:CHI individuals had significantly decreased relative frequencies of CD3+,CD4+ subpopulationsand CD4+/CD8+ ratio,and increased CD8+ subset percentage compared with uninfected individuals(all P < 0.001) . There was a significant linear relationship between the load of HBV DNA and the parameters of T-lymphocyte subpopulations(ANOVA linear trend test P < 0.01) . The parameters were also significantly worse among individuals whose mothers were known to be HBV carriers,and those having gained infection before the age of 8 years. In multiple regressions,after adjustment for age at HBV infection and status of maternal HBV infection,log copies of HBV DNA maintained its highly significant predictive coefficient on T-lymphocyte subpopulations,whereas the effect of HBeAg was not significant. CONCLUSION:HBV DNA correlates with modification in the relative T-lymphocyte subpopulation frequencies. High viral load is more powerful than HBeAg in predicting the impaired balance of T-cell subsets.

Analysis of Peripheral T-Lymphocyte Subpopulations in Patients with Early Syphilis by Flow Cytometry

Objective: To study the cellular immunity function of patients with early syphilis and the effects on immune modifiers Esberitox N or IFN. Methods: T-lymphocyte subpopulations of the peripheral blood in 44 patients with syphilis and 40 healthy controls were examined by flow cytometry. Results: The number of CD4+ cells and the CD4+/CD8+ ratio in patients with syphilis were found to be significantly lower than those in the control (P<0.01), while the number of CD8+cells was higher than that in the control (P<0.01). The CD4+/CD8+ ratio in those with active disease was lower than that in those who had been cured (P<0.05). The CD4+ count and the CD4+/CD8+ ratio in those treated with antibiotics alone(Penicillin G or Cephalosporins) were lower than those treated with both antibiotics and immunomodulators (P<0.05). Conclusions: Cellular immunity in the patients with early syphilis was prominently suppressed, and treatment with immunomodulators may be helpful for the recovery of cellular immunity of these patients.

Changes of T lymphocyte subpopulation and its relationship with Modified Bobath score in index stroke

Objective To analyze the correlation of changes of T lymphocyte subpopulation and Modified Bobath index in acute stroke.Method Peripheral blood CD3+,CD4+,CD8+,CD16+56+ and ratio of CD4+/CD8+ were measured using bicolor fluorescent monclonal antibody and flow cytometry and compared with those of 23 healthy controls. Simultaneously,relationship between modified Bobath index and changes of T lymphocytes subpopulation was analyzed.Result Compared with healthy controls, peripheral blood percent of CD3+,CD4+ of subjects with acute stroke was marked lower,which was positively correlated with modified Bobath index.Conclusion Immune response is involved in development of acute cerebrovascular diseases.Improving immune function is important for prevention and treatment of cerebrovascular diseases.

血清CAR LMR T淋巴细胞亚群与多发性骨髓瘤患者预后的相关性分析

目的:探讨血清C反应蛋白与白蛋白比值(CAR)、淋巴细胞/单核细胞比值(LMR)、T淋巴细胞亚群与多发性骨髓瘤(MM)患者预后的相关性。方法:选取2020年1月至2022年1月诊治的105例多发性骨髓瘤患者作为研究对象,设立为观察组,同期选取75例健康体检者设立为对照组。根据MM患者治疗后随访2年是否出现复发或死亡分为预后不良组(n=34)和预后良好组(n=71),对比血清CAR、LMR、T淋巴细胞亚群(CD3^(+)、CD4^(+)、CD8^(+)、CD4^(+)/CD8^(+))。采用Logistic回归分析CAR、LMR、CD3^(+)、CD4^(+)、CD8^(+)、CD4^(+)/CD8^(+)对MM患者预后的影响。采用ROC曲线模型分析CAR、LMR、CD3^(+)、CD4^(+)、CD8^(+)、CD4^(+)/CD8^(+)、T淋巴细胞亚群综合参数预测MM患者预后的AUC值、敏感度和特异度。结果:观察组的CAR、CD8^(+)高于对照组,而LMR、CD3^(+)、CD4^(+)、CD4^(+)/CD8^(+)低于对照组(P<0.05)。预后不良组的CAR、CD8^(+)高于预后良好组,而LMR、CD3^(+)、CD4^(+)、CD4^(+)/CD8^(+)低于预后良好组(P<0.05)。二元Logistic回归分析显示,CAR、CD8^(+)升高和LMR、CD3^(+)、CD4^(+)、CD4^(+)/CD8^(+)下降会对MM患者预后产生影响(P<0.05)。ROC曲线分析显示,CAR、LMR、CD3^(+)、CD4^(+)、CD8^(+)、CD4^(+)/CD8^(+)、T淋巴细胞亚群综合参数预测MM患者预后的AUC值分别为(0.637、0.792、0.726、0.767、0.669、0.750、0.853,P<0.05)。结论:血清CAR、LMR、T淋巴细胞亚群在MM患者中呈异常表达趋势,检测其变化有利于为评估MM患者的预后提供重要参考。

Effect of viral load on T-lymphocyte failure in patients with chronic hepatitis B

AIM: To investigate peripheral T-lymphocyte sub-population profile and its correlation with hepatitis B virus (HBV) replication in patients with chronic hepatitis B (CHB).METHODS: Distribution of T-lymphocyte subpopulations in peripheral blood was measured by flow cytometry in 206 CHB patients. HBV markers were detected with ELISA. Serum HBV DNA load was assessed with quantitative real-time polymerase chain reaction (PCR). The relationship between HBV replication and variation in peripheral T-cell subsets was analyzed.RESULTS: CHB patients had significantly decreased CD3+ and CD4+ cells and CD4+/CD8+ ratio, and increased CD8+ cells compared with uninfected controls (55.44 ± 12.39 vs 71.07 ± 4.76, 30.92 ± 7.48 vs 38.94 ± 3.39, 1.01 ± 0.49 vs 1.67 ± 0.33, and 34.39 ± 9.22 vs 24.02 ± 4.35; P < 0.001, respectively). Univariate analysis showed a similar pattern of these parameters was significantly associated with high viral load, presence of serum hepatitis B e antigen (HBeAg) expression, liver disease severity, history of maternal HBV infection, and young age at HBV infection, all with P < 0.01. There was a significant linear relationship between viral load and these parameters of T-lymphocyte subpopulations (linear trend test P < 0.001). There was a negative correlation between the levels of CD3+ and CD4+ cells and CD4+/CD8+ ratio and serum level of viral load in CHB patients (r = -0.68, -0.65 and -0.75, all P < 0.0001), and a positive correlation between CD8+ cells and viral load (r = 0.70, P < 0.0001). There was a significant decreasing trend in CD3+ and CD4+ cells and CD4+/CD8+ ratio with increasing severity of hepatocyte damage and decreasing age at HBV infection (linear trend test P < 0.01). In multiple regression (after adjustment for age at HBV infection, maternal HBV infection status and hepatocyte damage severity) log copies of HBV DNA maintained a highly significant predictive coefficient on T-lymphocyte subpopulations, and was the strongest predictor of variation in CD3+, CD4+, CD8+ cells and CD4+/CD8+ ratio. However, the effect of HBeAg was not significant.CONCLUSION: T-lymphocyte failure was signifi-cantly associated with viral replication level. The substantial linear dose-response relationship and strong independent predictive effect of viral load on T-lymphocyte subpopulations suggests the possibility of a causal relationship between them, and indicates the importance of viral load in the pathogenesis of T cell hyporesponsiveness in these patients.

外周血CD8+效应记忆T细胞对脓毒症诊断的价值评估

目的探讨CD8+T细胞各亚群在脓毒症诊断的价值。方法前瞻性选择2021年3月—2022年3月陆军军医大学大坪医院ICU收治的脓毒症和非脓毒症患者各30例作为研究对象。男性40例,女性20例;年龄29~70岁,平均55.4岁。创伤患者16例(包括道路交通伤7例,高处坠落伤5例,挤压伤3例,锐器伤1例)。采集患者入ICU后第1、3、5天外周血,用流式细胞仪检测T淋巴细胞及CD8+T细胞各亚群的比例,采用资料测量方差分析比较两组间差异,并采用两组间多重比较方法比较特定时间点两组间差异,单因素Logistic回归分析其与脓毒症发生相关的亚群;受试者工作特征(ROC)曲线评估其对脓毒症的诊断效能;Pearson检验分析其与脓毒症患者严重程度的相关性。结果脓毒症患者入ICU第1、3、5天的CD3+T淋巴细胞的比例显著低于非脓毒症患者[(54.32±16.44)%vs.(67.13±12.90)%、(59.42±14.49)%vs.(68.12±12.95)%、(58.81±17.47)%vs.(69.68±10.87)%,P均<0.05];进一步分析发现脓毒症患者入ICU第1、3、5天的CD8+效应记忆T细胞亚群的比例也显著低于非脓毒症患者[(25.45±10.55)%vs.(39.51±12.59)%、(27.38±11.19)%vs.(39.81±14.24)%、(28.56±12.38)%vs.(38.97±12.89)%,P均<0.05]。此外,脓毒症患者入ICU第3天的CD4+T淋巴细胞及CD8+Naive T细胞亚群的比例显著高于非脓毒症患者[(64.88±10.94)%vs.(57.51±13.49)%、(22.85±17.00)%vs.(14.47±7.32)%,P均<0.05];Logistic回归分析显示CD3+T淋巴细胞比例、CD8+效应记忆T细胞亚群比例、血浆降钙素原(PCT)及CRP水平是患者发生脓毒症的独立危险因素。ROC曲线分析显示,血浆PCT水平与CD8+效应记忆T细胞亚群比例联合诊断脓毒症的ROC曲线下面积(AUC)为0.890(0.775~0.995)。结论CD8+效应记忆T细胞的比例及血浆PCT水平二者联合对脓毒症诊断具有较好的效能。

Study on the blood-borne virus co-infection and T lymphocyte subset among intravenous drug users

AIM: To investigate the features of various blood- borne virus infections and co-infection in intravenous drug users (IDUs), and to examine the correlation of T lymphocyte subsets with virus co-infection. METHODS: Four hundred and six IDUs without any clinical manifestation of hepatitis and 102 healthy persons were enrolled in this study. HBV-DNA and HCV-RNA were detected by fluorescence quantitative PCR. HBsAg, HBeAg, anti-HBc, anti-HCV, HDV-Ag, anti-HGV, anti-HIV, and HCMV-IgM were assayed by enzyme-linked immunosorbent assay (ELISA) and immunochromatographic tests. The levels of Th1 and Th2 cytokines were measured by ELISA and radioactive immune assay (RIA). The T lymphocyte subpopulation was detected by using fluorescence immunoassay. The similar indices taken from the healthy persons served as controls. RESULTS: The viral infection rate among IDUs was 36.45% for HBV, 69.7% for HCV, 47.3% for HIV, 2.22% for HDV, 1.97% for HGV, and 3.45% for HCMV. The co- infection rate of blood-borne virus was detected in 255 of 406 (62.81%) IDUs. More than 80% (161/192) of subjects infected with HIV were co-infected with the other viruses, such as HBV, HCV. In contrast, among the controls, the infection rate was 17.65% for HBV and 0% for the other viruses. Our investigation showed that there was a profound decrease in the proportion of CD4/CD8 and the percentage of CD3 and CD4, but not in the percentage of CD8. The levels of PHA-induced cytokines (IFN-γ and IL-4) and serum IL-2 were obviously decreased in IDUs. On the other hand, the level ofserum IL-4 was increased. The level of IFN-γ and the percentage of CD4 were continuously decreased when the IDUs were infected with HIV or HIV co-infection. IDUs with HIV and HBV co-infection was 15.1% (29/192). Of those 29 IDU with HIV and HBV co-infection, 51.72% (15/29) and 37.93% (11/29) were HBV-DNA-positive and HBeAg-positive, respectively. But, among IDUs without HIV infection, only 1.68% (2/119) of cases were HBV- DNA-positive. CONCLUSION: HCV, HBV and HIV infections are common in this population of IDU, leading to a high incidence of impaired Th1 cytokine levels and CD4 lymphocyte. IDUs with HIV and HBV/HCV co-infection have lower expression of Th1 cytokine with enhancement of the Th2 response. HIV may be causing HBV replication by decreasing Th1 function.

Analysis of the T-Lymphocytes and Their Subpopu-lations of the Peripheral Blood in Patients with Urticaria

Objective: To study the function of cellular immunity of patients with urticaria.Methods:T-lymphocytes subpopulations of the peripheraal blood in 60 patients with urticaria and 40 henlthy controls were examined by flow cylonuetry. Results: The number of CD^3+ and CD^4+ cells in the urticaria group were significantly lower than those in the control group ( P<0. 01 ), especially in patients with acute urticaria. Conclusion: There was immunologic dysfunction of T lymphocyte in the patients with urticaria, and not only humoral immunity takes part but also cellular immunity plays a certain role in the pathogenesis of urticaria.

胃周围刺联合甲地孕酮对进展期肺癌患者食欲、营养状况及T淋巴细胞亚群的影响

目的:探讨胃周“围刺”联合甲地孕酮对进展期非小细胞肺癌患者食欲、营养状况及T淋巴细胞亚群的影响。方法:根据治疗方法不同将70例进展期肺癌患者分为对照组与治疗组,每组各35例。对照组给予醋酸甲地孕酮分散片口服治疗;治疗组在对照组的基础上联合胃周“围刺”治疗。治疗两周后,比较两组患者食欲及营养状况、免疫功能、生活质量。结果:治疗后,两组功能评估问卷(FAACT)各维度均提高,且治疗组功能状况、情感状况及附加关注状况维度评分均高于对照组(P<0.05)。治疗后,治疗组血清前白蛋白(PA)、CD4^(+)水平均高于对照组(P<0.05);欧洲癌症治疗研究组织生命质量-核心量表(EORTC QLQ-C30)中躯体功能、情绪功能及认知功能评分均高于对照组(P<0.05)。结论:胃周“围刺”联合甲地孕酮有利于促进进展期肺癌患者食欲恢复,改善营养状况及免疫功能,提高生活质量。

抗核抗体联合T淋巴细胞亚群检测对复发性流产妊娠结局的预测价值

目的:探究抗核抗体(ANA)联合T淋巴细胞亚群检测对复发性流产(RSA)妊娠结局的预测价值。方法:选择2020年2月—2022年7月赣州市妇幼保健院收治的50例RSA患者入研究组,另选择50例同期于本院行产前检查的正常妊娠孕妇入对照组。采集所有参检者清晨空腹肘静脉血5 mL,检测ANA、T淋巴细胞亚群(CD4^(+)、CD8^(+)、CD16^(+)CD56^(+))水平,并计算CD4^(+)/CD8^(+)值。结果:研究组29例患者于孕10周前发生流产,流产率为58.00%(29/50);对照组于孕10周前发生流产共13例,流产率为26.00%(13/50),两组流产率对比,差异有统计学意义(χ^(2)=10.509,P=0.001)。相比于对照组,研究组ANA阳性检出率较高,CD4^(+)、CD16^(+)CD56^(+)、CD4^(+)/CD8^(+)水平均较高,CD8^(+)水平较低,差异均有统计学意义(P<0.05)。联合检测在RSA中的预测价值最高,AUC为0.872,敏感度为0.875,特异度为0.393,其次为CD16^(+)CD56^(+)、CD4^(+)、CD4^(+)/CD8^(+)、CD8^(+)、ANA。结论:ANA联合T淋巴细胞亚群检测在RSA诊断中应用价值较高,能够有效预测RSA发生风险,为临床尽早干预提供可靠的参考。

慢性精神分裂症患者外周血T淋巴细胞水平及其亚群线粒体损伤情况

目的了解慢性精神分裂症患者外周血T淋巴细胞水平及其亚群线粒体损伤情况及其临床意义。方法选取慢性精神分裂症患者153例,采用流式细胞技术检测其外周血T淋巴细胞亚群水平及亚群线粒体功能损伤情况,按T淋巴细胞线粒体损伤指数分为线粒体损伤组(阳性组,n=53)与线粒体未损伤组(阴性组,n=100),比较两组患者间免疫功能差异。采用PANSS量表评估患者精神阴性症状得分,并进行相关性分析。结果PANSS阴性症状评分和PANSS总分,阴性组[(32.09±4.15)、(90.14±6.16)]均低于阳性组[(41.13±4.77)、(103.80±6.17)](t值=12.170、13.090,P值均<0.001)。CD45+T细胞、CD3+T细胞和CD8^(+)细胞毒性T细胞占比,阴性组[(34.83%±7.71%)、(67.23%±8.99%)、(25.60%±7.74%)]高于阳性组[(28.37%±7.84%)、(63.64%±10.05%)、(21.91%±7.17%)],CD4^(+)/CD8^(+)比值(1.64±0.68)低于阳性组(1.96±0.81)(t值=4.901、2.258、2.87、2.622,P值均<0.05)。CD3+T细胞、CD4^(+)辅助T细胞和CD8^(+)细胞毒性T细胞的绝对计数阴性组[(1565.0±462.4)、(887.9±319.0)、(591.0±232.6)/μL]高于阳性组[(986.0±320.0)、(607.3±251.5)、(328.1±104.6)/μL](t值=8.135、5.552、7.813,P值均<0.05)。慢性精神分裂症患者CD8^(+)细胞毒性T细胞水平与PANSS阴性症状分值呈线性负相关(r=-0.210,P=0.009)。结论T细胞亚群线粒体损伤阳性的慢性精神分裂症患者免疫指标下降明显,免疫抑制更显著。

胸腔镜微创手术对肺癌患者血清肿瘤标志物及T淋巴细胞亚群的影响

目的 探究胸腔镜微创手术对肺癌患者血清肿瘤标志物及T淋巴细胞亚群的影响。方法 将104例肺癌患者按不同手术治疗方案分成2组,每组52例。对照组予以传统开胸手术治疗,研究组予以胸腔镜微创手术治疗。对比2组手术相关指标和血清肿瘤标志物、T淋巴细胞亚群指标水平,并开展安全性评估。结果 研究组的手术时间和术中失血量、术后恢复时间均低于对照组,差异有统计学意义(P<0.05);2组淋巴结清扫数对比,差异无统计学意义(P>0.05)。术后24 h, 2组血清癌胚抗原(CEA)和糖类抗原125(CA125)水平均较术前低(P<0.05),但2组间血清CEA、CA125水平对比,差异无统计学意义(P>0.05)。术后d 7,2组CD3^(+)、CD4^(+)、CD8^(+)及CD4^(+)/CD8^(+)水平均较本组术前低,但研究组高于对照组,差异有统计学意义(P<0.05)。研究组治疗安全性优于对照组,差异有统计学意义(P<0.05)。结论 胸腔镜微创手术治疗肺癌优势明显,能降低血清肿瘤标志物含量,减轻手术治疗对T淋巴细胞亚群的影响,且并发症少,安全性更高,患者易接受。

PCT、IL-6和PA在新生儿细菌性感染中检测意义及与T淋巴细胞亚群水平关系

目的:探讨血清降钙素原(PCT)、白细胞介素6(IL-6)、前白蛋白(PA)在新生儿细菌感染性疾病(NBI)中的表达意义及与T淋巴细胞亚群水平。方法:回顾性收集2022年1月-2023年1月我院收治的150例NBI新生儿作为研究对象并纳入NBI组,另选取150例在我院进行正常体检的健康新生儿作为对照组,对比两组新生儿血清PCT、IL-6、PA及T淋巴细胞亚群水平;Pearson相关系数分析PCT、IL-6、PA与T淋巴细胞亚群水平的相关性;绘制受试者操作特征曲线(ROC)分析PCT、IL-6、PA单一及联合检测在新生儿NBI中的检测意义。结果:相比于对照组,NBI组新生儿血清PCT、IL-6、CD3+、CD4+表达显著上升,而PA、CD8+水平显著下降(均P<0.05);Pearson相关系数分析显示PCT、IL-6均与CD3+、CD4+呈显著正相关关系,但与CD8+呈负相关(均P<0.05);而PA则与CD3+、CD4+呈显著负相关,但与CD8+呈正相关(均P<0.05);ROC分析显示PCT、IL-6、PA联合检测的曲线下面积(AUC)显著高于任意指标单独检测(均P<0.05),敏感度为86.00%,特异度为86.67%。结论:PCT、IL-6、PA在NBI新生儿中均具有特异性表达,且与新生儿T淋巴细胞亚群水平之间具有较强关联性,临床通过联合检测PCT、IL-6、PA对NBI的发生发展具有良好的诊断价值,值得临床推广使用。

血清T淋巴细胞亚群水平变化与狼疮性肾炎患者疾病转归的相关性

目的探讨血清T淋巴细胞亚群水平与狼疮性肾炎(LN)患者疾病转归相关性,分析其对疾病转归的预测价值。方法选取2019年1月至2022年3月河南科技大学第一附属医院收治的82例LN患者为研究对象,依据治疗6个月后疾病转归情况分为转归良好组65例、转归不良组17例。分析不同组(治疗前、治疗1个月、3个月后)、不同病情严重程度血清T淋巴细胞亚群水平(CD4^(+)、CD3^(+)、CD16^(+)/CD56^(+)、CD19^(+))。分析T淋巴细胞亚群与生化指标、病情严重程度相关性。分析治疗1个月、3个月后T淋巴细胞亚群水平对疾病转归的预测价值。结果治疗1个月、3个月后转归良好组CD4^(+)、CD3^(+)、CD16^(+)/CD56^(+)高于转归不良组,CD19^(+)低于转归不良组(P<0.05);CD4^(+)、CD3^(+)、CD16^(+)/CD56^(+)与白蛋白、补体C3、补体C4呈正相关,其与尿素氮、病情严重程度呈负相关,而CD19^(+)与之相反(P<0.05);治疗1个月、3个月后各指标联合预测疾病转归的曲线下面积(AUC)大于单项预测(P<0.05)。结论血清T淋巴细胞亚群水平变化与LN患者疾病转归密切相关,联合检测其水平对疾病转归具有一定预测价值。

MM患者外周血CAR、NLR、T细胞亚群及NK细胞水平及与预后关系的分析

目的探讨多发性骨髓瘤(MM)患者外周血C反应蛋白(CRP)与白蛋白(Alb)比值(CAR)、中性粒细胞/淋巴细胞比值(NLR)、T细胞亚群及NK细胞水平及临床意义。方法采用回顾性研究方法,选取2016年1月至2022年1月在大连市中心医院治疗的MM患者76例。随访期间死亡患者20例,存活患者56例。分析不同临床特征及预后患者外周血CAR、NLR、T细胞亚群及NK细胞水平差异。结果不同性别、年龄MM患者外周血CAR、NLR、T细胞亚群及NK细胞水平比较,差异均无统计学意义(P>0.05);ISS分期Ⅲ期患者外周血CAR、NLR和CD8^(+)分别为0.75±0.13、2.84±0.63和(53.69±4.17)%,均明显高于Ⅰ~Ⅱ期患者[0.55±0.14、2.49±0.58、(46.29±4.06)%],CD3^(+)、CD4^(+)和CD4^(+)/CD8^(+)分别为(56.00±5.81)%、(25.98±3.91)%和0.49±0.14,均明显低于Ⅰ~Ⅱ期患者[(64.42±5.90)%、(32.18±3.80)%、0.70±0.17],差异均有统计学意义(P<0.05);ISS分期Ⅰ~Ⅱ期和Ⅲ期患者NK细胞比较,差异无统计学意义(P>0.05)。死亡患者ISS分期Ⅲ期比例为60.00%,明显高于存活患者(25.00%),外周血CAR和NLR分别为0.69±0.17和3.01±0.65,明显高于存活患者(0.60±0.14、2.47±0.60),而卡氏评分和CD4^(+)/CD8^(+)为(60.25±6.14)分和0.57±0.10,均明显低于存活患者[(67.30±7.11)分、0.64±0.12],差异均有统计学意义(P<0.05)。Logistic回归分析显示:ISS分期、CAR、NLR和CD4^(+)/CD8^(+)是MM患者死亡的影响因素(P<0.05)。外周血CAR、NLR和CD4^(+)/CD8^(+)预测死亡的ROC曲线下面积分别为0.756、0.686和0.649,可见外周血CAR预测价值中等(P<0.05)。结论外周血CAR、NLR、CD3^(+)、CD4^(+)、CD4^(+)/CD8^(+)和CD8^(+)与患者ISS分期及预后有关,其中CAR在预测MM患者预后方面有一定应用价值。

T淋巴细胞亚群、血管内皮功能指标与脓毒症患者预后的关系

目的分析脓毒症患者T淋巴细胞亚群及血管内皮功能指标与其预后的关系。方法选取2020年1月至2023年1月我院收治的脓毒症患者150例,根据患者1个月内死亡情况分为死亡组与存活组,记录T淋巴细胞亚群、血管内皮功能指标,并对影响脓毒症患者预后的因素进行Logistic回归分析。结果死亡组CD3^(+)、CD4^(+)水平低于存活组,CD8+水平高于存活组(P<0.05)。死亡组血清血管性假血友病因子(vWF)、内皮素-1(ET-1)水平高于存活组,一氧化氮(NO)水平低于存活组(P<0.05)。CD8^(+)、vWF、ET-1为脓毒症患者1个月内死亡的危险因素(OR>1,P<0.05),CD3^(+)、CD4^(+)及NO则为保护因素(OR<1,P<0.05)。结论T淋巴细胞亚群、血管内皮功能指标与脓毒症患者预后具有相关性,临床治疗需调节患者免疫力并改善其血管内皮功能。

芪珍胶囊辅助治疗对乳腺癌T淋巴细胞亚群肿瘤标志物的影响及预后分析

目的:探究芪珍胶囊辅助治疗对乳腺癌T淋巴细胞亚群、肿瘤标志物及预后的影响。方法:选2019年1月至2021年1月我院收入并治疗的乳腺癌患者80例为研究对象,依据随机数字表采用简单随机分组方法将其分为对照组、观察组,每组40例,两组患者均接受EC化疗干预方案(环磷酰胺+阿霉素+氟尿嘧啶),观察组在此基础上联合芪珍胶囊口服治疗,两组患者均连续治疗6周。比较两组患者血常规情况、T淋巴细胞亚群(CD3^(+)、CD4^(+)、CD8^(+))、肿瘤标志物指标[癌胚抗原(CEA)、糖类抗原153(CA153)、癌抗原125(CA125)]水平,截至随访2023年2月28日,分析两组患者中位无病生存期差异。结果:治疗前,两组患者红细胞、白细胞、血小板比较无显著差异(P>0.05)。治疗后,观察组白细胞、血小板治疗前后差值大于对照组(P<0.05)。治疗前,两组患者CD3^(+)、CD4^(+)、CD8^(+)比较无显著差异(P>0.05)。治疗后,观察组CD3^(+)、CD4^(+)治疗前后差值大于对照组(P<0.05)。治疗前,两组患者CEA、CA153、CA125比较无显著差异(P>0.05)。治疗后,两组CEA、CA153、CA125均降低,且观察组CEA、CA153、CA125治疗前后差值大于对照组(P<0.05)。截至随访2023年2月28日,观察组病情复发转移4例,对照组病情复发转移11例,与对照组相比,观察组无病生存期更高,生存优势更明显(χ^(2)=7.195,P=0.007)。两组患者治疗不良反应发生率比较无显著差异(P>0.05)。结论:芪珍胶囊辅助治疗可改善乳腺癌患者T淋巴细胞亚群、肿瘤标志物及术后生存情况,且用药安全性有一定保障。

含贝达喹啉方案对耐多药肺结核患者T淋巴细胞亚群及炎症因子的影响

目的:探讨含贝达喹啉方案治疗耐多药肺结核患者的临床效果及对T淋巴细胞亚群的影响。方法:选取2020年6月—2022年6月赣州市第五人民医院收治的82例耐多药肺结核患者,按随机数字表法分为两组,各41例。对照组予以常规抗结核治疗,观察组加用贝达喹啉治疗。比较两组临床疗效、痰菌转阴率、病灶吸收率、T淋巴细胞亚群、血清炎症水平及不良反应。结果:观察组总有效率、痰菌转阴率、病灶吸收率均较对照组高,差异均有统计学意义(P<0.05);观察组治疗后CD3^(+)、CD4^(+)、CD4^(+)/CD8^(+)分别为(68.68±5.31)%、(39.64±4.18)%、(1.88±0.21),高于对照组的(63.24±5.18)%、(35.52±4.14)%、(1.54±0.19),CD8^(+)为(21.14±2.15)%,低于对照组的(23.05±2.21)%,差异均有统计学意义(P<0.05);观察组治疗后白介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)、C反应蛋白(CRP)水平分别为(18.73±1.43)pg/mL、(42.15±4.96)pg/mL、(8.22±1.08)mg/L,低于对照组的(20.35±1.54)pg/mL、(50.33±5.02)pg/mL、(10.23±1.57)mg/L,差异均有统计学意义(P<0.05);两组不良反应发生率相比,差异无统计学意义(P>0.05)。结论:含贝达喹啉方案可提高MDR-TB治疗效果,减轻肺部炎症反应,加快痰菌转阴,纠正T淋巴细胞亚群紊乱,安全可靠。