改良衰弱指数与2型糖尿病并发肺部感染患者高炎症状态和免疫功能失调的关系  

Relationship between modified frailty index and high inflammatory status and immune dysfunction of type 2 diabetes mellitus patients complicated with pulmonary infection

作　　者：毛立群[1] 张添威 郭微微 王星钧 盛芬[1] MAO Li-qun;ZHANG Tian-wei;GUO Wei-wei;WANG Xing-jun;SHENG Fen(Taizhou First Peopled Hospital,Taizhou,Zhejiang 318020,China)

机构地区：[1]台州市第一人民医院呼吸和危重医学科,浙江台州318020

出　　处：《中华医院感染学杂志》2021年第1期10-14,共5页Chinese Journal of Nosocomiology

基　　金：浙江省医药卫生科技计划基金资助项目(2019KY779)。

摘　　要：目的分析改良衰弱指数(modified Frailty Index,mFI)与2型糖尿病(Type 2 diabetes mellitus, T2DM)并发肺部感染患者高炎症状态和免疫功能失调的关系。方法选取2017年1月-2019年12月台州市第一人民医院收治的T2DM患者205例,依据是否并发肺部感染将其分为感染组60例、未感染组145例,比较两组患者入院时mFI、肺功能指标[1s用力呼气量(FEV1)、最大通气量(MMV)、最大呼气中期流量(MMEF)、肺总量(TLC)、功能残气量(FRC)]及血清炎症因子[C-反应蛋白(CRP)、降钙素原(PCT)、肿瘤坏死因子-α(TNF-α)、白细胞介素-6(IL-6)]和免疫功能指标(T淋巴细胞亚群CD_(3)^(+)、CD_(4)^(+)、CD_(8)^(+)、CD_(4)^(+)/CD_(8)^(+))水平,比较感染组中不同感染程度、衰弱与否患者的肺功能、血清炎症因子水平及免疫功能指标。结果感染组患者mFI高于未感染组,FEV1、MVV、MMEF、FRC低于未感染组(P<0.05),两组TLC比较差异无统计学意义;感染组入院时血清CRP、PCT、IL-6、TNF-α水平均高于未感染组(P<0.05);CD_(3)^(+)、CD_(4)^(+)、CD_(4)^(+)/CD__(8)^(+)高于未感染组(P<0.05),两组CD__(8)^(+)比较差异无统计学意义;T2DM并发肺部感染患者中,衰弱患者FEV1、MVV、MMEF低于无衰弱患者,血清CRP、PCT、TNF-α、CD_(3)^(+)、CD_(4)^(+)高于无衰弱患者(P<0.05);Pearson相关分析发现,T2DM并发肺部感染患者mFI与FEV1、MVV呈负相关,与血清CRP、PCT、CD_(3)^(+)呈正相关(P<0.05)。结论 T2DM并发肺部感染患者mFI与其高炎症状态及免疫功能失调有密切关系,应加强对T2DM患者的综合管理。OBJECTIVE To analyze the relationship between the modified frailty index(mFI)and the high inflammatory status and immune dysfunction of the type 2 diabetes mellitus(T2 DM)patients complicated with pulmonary infection.METHODS A total of 205 patients with T2 DM who were treated in Taizhou First People′s Hospital from Jan 2017 to Dec 2019 were enrolled in the study and divided into the infection group with 60 cases and the non-infection group with 145 cases according to the status of pulmonary infection.The mFI,pulmonary function indexes[forced expiratory volume in 1 second(FEV1),maximal voluntary ventilation(MMV),maximal mid-expiratory flow(MMEF),total lung capacity(TLC),functional residual capacity(FRC)],levels of serum inflammatory factors[C-reactive protein(CRP),procalcitonin(PCT),tumor necrosis factor-α(TNF-α),interleukin-6(IL-6)]and immune function indicators(T lymphocyte subsets CD_(3)^(+),CD_(4)^(+),CD_(8)^(+),CD_(4)^(+)/CD_(8)^(+))were compared between the two groups of patients at the admission to hospital.The pulmonary function,levels of serum inflammatory factors and immune function indexes were compared among the patients with different degree of infection and between the patients with frailty and the patients without frailty in the infection group.RESULTS The mFI of the infection group was significantly higher than that of the non-infection group,the FEV1,MVV,MMEF and FRC of the infection group were significantly lower than those of the non-infection group(P<0.05),and there was no significant difference in the TLC between the two groups.The levels of serum CRP,PCT,IL-6 and TNF-αof the infection group were significantly higher than those of the non-infection group at the admission to hospital(P<0.05),the CD_(3)^(+),CD_(4)^(+)and CD_(4)^(+)/CD_(8)^(+)of the infection group were significantly higher than those of the non-infection group(P<0.05),and there was no significant difference in the CD_(8)^(+)between the two groups.Among the T2 DM patients complicated with pulmonary infection,the FEV1,MVV and

关 键 词：改良衰弱指数 2型糖尿病 肺部感染 炎症 免疫功能失调 

分 类 号：R587.2[医药卫生—内分泌]