新型冠状病毒感染患者免疫功能与胸部CT表现之间的关系  

Relationship between immune function and chest CT findings in patients with SARS-CoV-2

作　　者：王利娟 李华 魏霞 WANG Lijuan;LI Hua;WEI Xia(Department of Pulmonary and Critical Care Medicine,Ninth Hospital of Xi′an,Xi′an,Shaanxi 710054,China;Department of Pulmonary and Critical Care Medicine,Linfen Central Hospital,Linfen,Shanxi041000,China)

机构地区：[1]西安市第九医院呼吸与危重症医学科,陕西西安710054 [2]临汾市中心医院呼吸与危重症医学科,山西临汾041000

出　　处：《临床肺科杂志》2025年第1期1-7,共7页Journal of Clinical Pulmonary Medicine

摘　　要：目的 通过研究不同疾病严重程度新冠患者TBNK淋巴细胞亚群与肺部定量CT参数之间的关系,为评估疾病发展提供更多可能的指标,为临床早期评估及治疗提供更多证据。方法 回顾性收集确诊新冠病毒感染的165例患者的外周血TBNK淋巴细胞亚群(CD3^(+)T细胞、CD4^(+)T细胞、CD8^(+)T细胞、B细胞、NK细胞)中各细胞的计数及占比,并采用数字肺软件工作系统计算肺部病变体积、占比、密度、质量及磨玻璃体积百分比(PGV)、实性体积百分比(PCV)、半实性体积百分比(PSV)的值,并分析不同严重程度患者免疫功能与肺部病变各参数间的相关性。结果 患者疾病越严重年龄越大(P<0.001),合并的基础疾病越多(P<0.05),其中脑梗死和高血压的占比更高(P<0.05);危重型患者的CD3^(+)T细胞、CD4^(+)T细胞、CD8^(+)T细胞、B细胞计数与其他组相比明显减低(P<0.001);危重型患者的肺部病变体积、肺部病变体积占比、病变密度、病变质量较其他组明显增加(P<0.001);除了NK细胞外,其余淋巴细胞亚群与疾病严重程度呈现负相关(P<0.001);淋巴细胞、CD3^(+)T细胞、CD4^(+)T细胞、CD8^(+)T细胞、B细胞、NK细胞计数与全肺病变体积百分比呈负相关(P<0.05),淋巴细胞、CD3^(+)T细胞、CD4^(+)T细胞、CD8^(+)T细胞、B细胞、NK细胞计数与PGV呈正相关,与PSV、PCV呈负相关。结论 与非危重型新冠患者相比,危重型患者淋巴细胞计数更低、肺部病变占比更大,免疫功能与肺部病变明显相关,早期评估TBNK淋巴细胞亚群、肺部病变占比对临床指导治疗和改善不良预后有重要意义。Objective To investigate the relationship between TBNK lymphocyte subsets and lung quantitative CT parameters in SARS-CoV-2 patients with different disease severity,so as to provide more possible indicators for assessing the development of the disease and provide more evidence for early clinical evaluation and treatment.Methods The counts and proportions of TBNK lymphocyte subsets(CD3^(+)T cells,CD4^(+)T cells,CD8^(+)T cells,B cells,NK cells)in the peripheral blood of 165 patients diagnosed with SARS-CoV-2 infection were retrospectively collected.The volume,proportion,density,mass,percentage of groud-grass opacity volume(PGV),the percentage of consolidation volume(PCV),and the percentage of semi-consolidation volume(PSV)of lung lesions were calculated by the digital pulmonary software system,and the correlation between immune function and parameters of lung lesions in patients with different severity were analyzed.Results The more serious the disease was,the older the patients were(P<0.001),the more underlying diseases were complicated(P<0.05),and the proportions of cerebral infarction and hypertension were higher(P<0.05);The counts of CD3^(+)T cells,CD4^(+)T cells,CD8^(+)T cells,and B cells in critically ill patients were significantly lower than those in other groups(P<0.001).The lung lesion volume,proportion of lung lesion volume,lesion density,and lesion mass of critical patients were significantly increased compared with other groups(P<0.001);Except for NK cells,other lymphocyte subsets were negatively correlated with disease severity(P<0.001).The counts of lymphocytes,CD3^(+)T cells,CD4^(+)T cells,CD8^(+)T cells,B cells,and NK cells were negatively correlated with the percentage of total lung lesion volume ( P <0.05). The counts of lymphocytes, CD3 ^(+)T cells, CD4 ^(+)cells, CD8 ^(+)cells, B cells, and NK cells were positively correlated with PGV, and negatively correlated with PSV and PCV. Conclusion Compared with non-critically ill patients, critically ill patients have lower lymphocyte count and a large

关 键 词：新型冠状病毒感染 淋巴细胞亚群 肺部定量CT 

分 类 号：R511[医药卫生—内科学]