CD4^(+)T淋巴细胞ATP值在预测矽肺患者反复呼吸道感染中的价值  

The value of adenosine triphosphate in CD4^(+)T lymphocytes in predicting repeated respiratory tract infections in silicosis patients

作　　者：张添威 郭微微 王笑咪 毛立群[1] 张蓉映[1] Zhang Tianwei;Guo Weiwei;Wang Xiaomi;Mao Liqun;Zhang Rongying(Department of Respiratory Medicine,the First People's Hospital of Taizhou,Taizhou 318020,China)

机构地区：[1]台州市第一人民医院呼吸内科,318020

出　　处：《中华劳动卫生职业病杂志》2020年第12期915-918,共4页Chinese Journal of Industrial Hygiene and Occupational Diseases

摘　　要：目的探讨CD4^(+)T淋巴细胞三磷酸腺苷(ATP)值在预测矽肺患者反复呼吸道感染(RRTI)中的价值。方法于2020年4月,以2016年3月至2018年3月收治的614例矽肺患者(分为RRTI组105例和非RRTI组509例)为研究对象和同期30例健康体检者作为健康对照组,Immuknon技术检测比较各组研究对象CD4^(+)T淋巴细胞ATP值的差异,并绘制受试者工作特征(ROC)曲线分析CD4^(+)T淋巴细胞ATP值在预测矽肺患者发生RRTI中的价值。采用logistic回归分析探讨RRTI的危险因素。结果矽肺患者RRTI发生率为17.10%(105/614);RRTI组患者CD4^(+)T淋巴细胞ATP值[(260.42±90.36)mg/L]明显低于非RRTI组[(413.66±138.74)mg/L],差异有统计学意义(t=-10.849,P<0.01)。ROC曲线下面积为0.834,截断值为284 mg/L,敏感度为0.88,特异度为0.83。logistic回归分析提示,CD4^(+)T淋巴细胞ATP值≤284 mg/L、通气功能损伤、血白蛋白<40 g/L和糖尿病是矽肺患者发生RRTI的危险因素(OR=2.126、1.217、1.164、1.125,P<0.05)。结论CD4^(+)T淋巴细胞ATP值低是矽肺患者RRTI的危险因素,可以预测矽肺患者发生RRTI的风险。Objective To explore the value of the concentration of adenosine triphosphate(ATP)in CD4^(+)T lymphocytes in predicting repeated respiratory tract infections(RRTI)in silicosis patients.Methods In April 2020,614 silicosis patients admitted from March 2016 to March 2018 were included in the study,and they were divided into the RRTI group(n=105)and the non RRTI group(n=509)according to whether the occurrence of RRTI,another 30 healthy cases taken from body check were served as control group,and the concentrations of ATP produced by CD4^(+)T lymphocytes was measured by ImmuKnow assay,and were compared between the three groups.And drawed the receiver operating characteristic(ROC)curve,and the Logistic regression analysis was used to explore the risk factors of RRTI.Results The incidence of RRTI in silicosis patients was 17.10%(105/614).The concentration of ATP produced by CD4^(+)T lymphocytes in the RRTI group[(260.42±90.36)mg/L]was significantly lower than that in the non RRTI group[(413.66±138.74)mg/L](t=-10.849,P<0.01).The area under the ROC curve was 0.834,the cutoff value was 284 mg/L,the sensitivity was 0.88,and the specificity was 0.83.Logistic regression analysis showed that the concentration of ATP produced by CD4^(+)T lymphocytes≤284 mg/L,impaired pulmonary ventilation function,serum albumin<40 g/L and diabetes were the risk factors of RRTI in silicosis patients(OR=2.126,1.217,1.164,1.125,P<0.05).Conclusion Low CD4^(+)T lymphocyte ATP value was a risk factor of RRTI in silicosis patients,and can predict the risk of RRTI in patients with silicosis.

关 键 词：矽肺 三磷酸腺苷 反复呼吸道感染 危险因素 

分 类 号：R135.2[医药卫生—劳动卫生]