AECOPD患者免疫功能及其血清PCT水平与病情严重程度相关性研究  

Correlation between immune function,serum PCT level and disease severity in AECOPD patients

作　　者：潘彬[1] 杨帆[1] 马春兰[1] PAN Bin;YANG Fan;MA Chun-lan(Department of Respiratory and Critical Care Medicine,the First Affiliated Hospital of Chengdu Medical College,Chengdu,Sichuan 610500,China)

机构地区：[1]成都医学院第一附属医院呼吸与危重症医学科,四川成都610500

出　　处：《热带医学杂志》2021年第2期184-187,共4页Journal of Tropical Medicine

基　　金：国家自然科学基金(81600388)。

摘　　要：目的研究慢性阻塞性肺疾病急性加重期(AECOPD)患者免疫功能及其血清降钙素原(PCT)水平与病情严重程度的关系。方法将94例AECOPD患者根据病情轻重分为呼吸衰竭组(n=36)和非呼吸衰竭组(n=58),均给予吸氧、抗感染、解痉平喘等对症支持治疗,并于入院后第2天采集空腹外周静脉血5 mL进行相关检查,比较两组各项检查结果并分析各项指标与病情严重程度的相关性。结果呼吸衰竭组CD3^(+)、CD4^(+)、CD4^(+)/CD8^(+)、NK细胞及第1秒呼气容积(FEV1)、FEV1占预计值百分比(FEV1%)和FEV1/FVC水平均低于非呼吸衰竭组,CD8^(+)细胞比例及血清IgG、C3、C4和PCT水平高于非呼吸衰竭组,差异有统计学意义(P<0.05)。两组肺部感染发生率分别为47.22%和20.69%(P<0.05),死亡率分别为5.56%和1.72%(P>0.05)。Pearson积差分析显示,AECOPD患者血清PCT水平与CD4^(+)/CD8^(+)和NK细胞比例呈负相关性,与血清IgG以及C3、C4水平呈正相关性,差异有统计学意义(P<0.05)。结论AECOPD患者免疫功能异常是病情严重程度增加的重要原因,其原因可能与肺部感染和炎症反应关系密切,积极改善患者免疫功能对缓解病情和改善预后具有重要意义,且检测血清PCT水平有利于评估病情轻重。Objective To study the relationship between immune function,serum procalcitonin(PCT)level and disease severity in patients with acute exacerbation of chronic obstructive pulmonary disease(AECOPD).Methods According to the severity of disease,patients were divided into respiratory failure group(n=36)and non-respiratory failure group(n=58).All patients were given symptomatic supportive treatments such as oxygen inhalation,anti-infection,spasmolysis and asthma calm-down.And the 5 mL fasting peripheral venous blood was collected on the 2ndd after admission for related examinations,and the differences of examination results were compared between the two groups,and the correlation between indexes and disease severity was analyzed.Results The levels of CD3^(+),CD4^(+),CD4^(+)/CD8^(+),NK cells,forced expiratory volume in one second(FEV1),FEV1%and FEV1/FVC in respiratory failure group were lower than those in non-respiratory failure group while the CD8^(+)cell proportion and levels of serum IgG,C3,C4 and PCT were higher than those in non-respiratory failure group(P<0.05).The incidence rates of pulmonary infection in the two groups were 47.22%and 20.69%,respectively(P<0.05),and the mortality rates were 5.56%and 1.72%,respectively(P>0.05).Pearson product-moment analysis showed that serum PCT level in patients with AECOPD was negatively correlated with CD4^(+)/CD8^(+)and NK cell proportion,and was positively correlated with serum IgG,C3 and C4 levels(P<0.05).Conclusions The abnormal immune function of patients with AECOPD was an important reason for the increase in the severity of disease,and the cause might be closely related to pulmonary infection and inflammatory response.Actively improving the immune function of patients should be of great significance in alleviating the disease and improving the prognosis.The detection of serum PCT level was conducive to evaluating the severity of disease.

关 键 词：慢性阻塞性肺疾病急性加重期 降钙素原 CD3+ CD4+ CD4+/CD8+ 

分 类 号：R563[医药卫生—呼吸系统]