间质性肺疾病急性加重患者外周血淋巴细胞亚群特点分析  

Characteristics of peripheral blood lymphocyte subsets in patients with acute exacerbation of interstitial lung disease

作　　者：王明明 宋立强 陈洁 杨学敏 吴运福 WANG Mingming;SONG Liqiang;CHEN jie;YANG Xuemin;WU Yunfu(Department of Pulmonary and Critical Care Medicine,Xijing Hospital,Air Force Military Medical University,Xi'an,Shaanxi 710032,China)

机构地区：[1]空军军医大学西京医院呼吸与危重症医学科,陕西西安710032

出　　处：《临床肺科杂志》2024年第5期660-664,共5页Journal of Clinical Pulmonary Medicine

基　　金：国家自然科学基金面上项目(No.81570072);陕西省重点研发项目(No.2022JZ-58)。

摘　　要：目的 分析间质性肺疾病急性加重(AE-ILD)患者外周血淋巴细胞亚群特点,并分析其与AE-ILD预后的相关性。方法 本研究收集了2020年1月至2022年12月我院呼吸重症监护室收治的AE-ILD患者的临床数据及实验室检查结果,通过统计学方法分析AE-ILD患者淋巴细胞亚群特点以及AE-ILD患者死亡的危险因素。结果 本研究共纳入29例AE-ILD患者,外周血总T淋巴细胞中位数为567个/μL,辅助T细胞中位数为284个/μL,抑制T细胞中位数175个/μL,B淋巴细胞中位数为135个/μL,NK细胞中位数为67个/μL。住院死亡12人(41.4%),与好转组相比,死亡组患者具有较高的呼吸频率、D-二聚体和IL-6水平,较低的辅助T细胞和NK细胞计数(P<0.05),Logistic回归分析结果显示辅助T细胞计数降低是AE-ILD患者死亡的独立危险因素(OR:1.007,95%CI:1.001~1.014,P=0.035),ROC曲线检测辅助T细胞对AE-ILD患者死亡的预测效果,曲线下面积为0.800(95%CI:0.585~1.000,P=0.020)。结论 AE-ILD患者外周血T淋巴细胞绝对计数减少,且辅助T淋巴细胞可作为AE-ILD患者的死亡预测因素。Objective To analyze the characteristics of lymphocyte subsets in the peripheral blood of patients with acute exacerbation of interstitial lung disease(AE-ILD) and its correlation with the prognosis of AE-ILD.Methods The clinical data and laboratory examination results of AE-ILD patients admitted to the respiratory intensive care Unit of our hospital from January 2020 to December 2022 were collected.The lymphocyte subsets of AE-ILD patients and the risk factors of death in AE-ILD patients were statistically analyzed.Results A total of 29 AE-ILD patients were included in this study,with a median peripheral blood T lymphocytes of 567/μL,helper T cells of 284/μL,suppressor T cells of 175/μL,B lymphocytes of 135/μL,and NK cells of 67/μL.Twelve patients(41.4%) died in hospital.Compared with the improved group,patients in the dead group had higher respiratory rate,D-dimer and IL-6 levels,and lower helper T cell and NK cell counts(P<0.05).Logistic regression analysis showed that the decrease in the count of helper T cell was an independent risk factor for death in AE-ILD patients(OR:1.007,95%CI:1.001~1.014,P=0.035),ROC curve to detect the predictive effect of helper T cells on death in AE-ILD patients,the area under the curve was 0.800(95% CI:0.585~1.000,P=0.020).Conclusion The absolute count of peripheral blood T lymphocytes was decreased in AE-ILD patients and helper T lymphocytes can be used as a predictor of death in AE-ILD patients.

关 键 词：间质性肺疾病 急性加重 淋巴细胞亚群 辅助T淋巴细胞 死亡危险因素 

分 类 号：R563[医药卫生—呼吸系统]