调节性T细胞表达与重症肺炎机械通气治疗患者撤机结局的关系  

Relationship between regulatory T cell expression and weaning outcome in patients with severe pneumonia treated by mechanical ventilation

作　　者：赵艳琳 高丽晓 Zhao Yanlin;Gao Lixiao(Department of Respiratory and Critical Care MedicineⅡ,Xinmi Hospital of Traditional Chinese Medicine,Xinmi 452370,China;Dengfeng People’s Hospital,Dengfeng 452470,China)

机构地区：[1]新密市中医院呼吸与危重症二科,新密452370 [2]登封市人民医院,登封452470

出　　处：《中国实用医刊》2023年第12期51-54,共4页Chinese Journal of Practical Medicine

摘　　要：目的探讨调节性T细胞表达与接受机械通气治疗的重症肺炎患者撤机结局的关系。方法本研究采用前瞻性分析。纳入2021年10月至2022年10月于新密市中医院接受机械通气治疗的重症肺炎患者110例,并记为重症肺炎组;另纳入同期收治的普通肺炎患者98例作为普通肺炎组。并根据撤机结局将重症肺炎组患者分为撤机成功组(78例)和撤机失败组(32例)。比较重症肺炎组与普通肺炎组患者调节性T细胞水平,比较撤机成功组与撤机失败组患者的一般资料及入院时的实验室指标[调节T细胞CD4^(+)CD25^(+)、血小板计数(PLT)、白细胞计数(WBC)、白蛋白(ALB)及C反应蛋白(CRP)]。采用Logistic回归分析法分析调节性T细胞CD4^(+)CD25^(+)表达对重症肺炎患者撤机结局的影响。结果重症肺炎组患者调节性T细胞CD4^(+)CD25^(+)水平[(9.31±2.54)%]高于普通肺炎组患者[(7.01±2.12)%],P<0.05。撤机成功组与撤机失败组患者年龄、性别、体质指数、病程、病史、PLT、WBC水平比较,差异未见统计学意义(P>0.05);撤机失败组患者调节T细胞CD4^(+)CD25^(+)、CRP水平高于撤机成功组,而ALB水平低于撤机成功组(P<0.05)。多因素Logistic回归分析结果显示,调节T细胞CD4^(+)CD25^(+)、CRP是影响撤机结局的危险因素(OR>1,P<0.05),ALB是影响撤机结局的保护因素(OR<1,P<0.05)。结论调节性T细胞是影响重症肺炎患者机械通气撤机结局的独立因素,可预测重症肺炎患者的撤机结局。Objective To investigate the relationship between regulatory T cell expression and weaning outcome in patients with severe pneumonia treated by mechanical ventilation treatment.Methods This study was a prospective trail.A total of 110 patients with severe pneumonia who received mechanical ventilation in Xinmi Hospital of Traditional Chinese Medicine from October 2021 to October 2022 were selected,and they were included in the severe pneumonia group;another 98 patients with common pneumonia admitted to the hospital during the same period were included as the common pneumonia group.According to the outcome of weaning,patients in the severe pneumonia group were divided into weaning success group(78 cases)and weaning failure group(32 cases).The levels of regulatory T cell of the severe pneumonia group and the common pneumonia group were compared.The general data and laboratory indicators at admission,including cluster of differentiation 4+and cluster of differentiation 25+(CD4+CD25+)regulatory T cells,platelet count(PLT),white blood cell count(WBC),albumin(ALB),C-reactive protein(CRP),were compared between the weaning success group and the weaning failure group.Logistic regression analysis was used to investigate the influence of the expression of CD4+CD25+regulatory T cells on weaning outcome in patients with severe pneumonia.Results The level of CD4+CD25+regulatory T cells in the severe pneumonia group was(9.31±2.54)%,higher than the(7.01±2.12)%in the common pneumonia group(P<0.05).There was no statistically significant difference in age,gender,body mass index,course of disease,history of disease,PLT and WBC between the weaning success group and the weaning failure group(P>0.05).The levels of CD4+CD25+regulatory T cells and CRP in the weaning failure group were significantly higher than those in the weaning success group,while the level of ALB was significantly lower than that in the weaning success group(P<0.05).The results of multivariate logistic regression analysis showed that CD4+CD25+regulatory T cells and

关 键 词：调节性T细胞 机械通气 重症肺炎 撤机结局 

分 类 号：R563.1[医药卫生—呼吸系统]