外周血T淋巴细胞亚群对老年重症肺炎患者短期院内转归的预测价值<sup>*</sup>

doi:10.3969/j.issn.1671-7171.2025.10.006

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摘要【目的】探讨外周血T淋巴细胞亚群对老年重症肺炎患者短期院内转归的预测价值。【方法】回顾性分析2021年6月至2023年11月本院收治的80例老年重症肺炎患者的临床资料,所有患者均接受常规治疗,根据治疗28 d后的疗效分为转归不良组(n=26)、转归良好组(n=54)。收集患者的一般资料,检测患者外周血T淋巴细胞亚群(CD3⁺、CD4⁺、CD8⁺)计数。采用受试者工作特征(ROC)曲线分析外周血T淋巴细胞亚群对老年重症肺炎患者短期院内转归不良的预测价值;采用多因素Logistic回归分析老年重症肺炎患者短期院内转归不良的危险因素。【结果】与转归良好组相比,转归不良组患者急性生理与慢性健康状况Ⅱ(APACHE Ⅱ)评分＞25分、胸腔积液患者占比较高(P<0.05),外周血CD3⁺、CD4⁺、CD8⁺计数较低(P<0.05)。 ROC曲线分析结果显示: CD3⁺、CD4⁺、CD8⁺预测老年重症肺炎患者短期院内转归不良的曲线下面积(AUC)分别为0.775、0.757、0.889(均P<0.05)。多因素Logistic回归分析结果显示:APACHE Ⅱ评分＞25分、胸腔积液、CD3⁺≤772.195个/μL、CD4⁺≤364.506个/μL、CD8⁺≤338.052个/μL是老年重症肺炎患者短期院内转归不良的危险因素(P<0.05)。【结论】老年重症肺炎患者短期院内转归不良可能与存在胸腔积液、APACHE Ⅱ评分较高有关。另外,转归不良的患者外周血CD3⁺、CD4⁺、CD8⁺计数较低,该指标可作为评估和预测老年重症肺炎患者院内转归不良的参考指标。

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	吕骁
	张宏英
	潘建光

关键词 ：肺炎, 危重病, T淋巴细胞亚群, 预后

Abstract：【Objective】To explore the predictive value of peripheral blood T lymphocyte subsets for short-term in-hospital outcomes in elderly patients with severe pneumonia. 【Methods】The clinical data of 80 elderly patients with severe pneumonia admitted to our hospital from June 2021 to November 2023 were retrospectively analyzed. All patients received conventional treatment and were divided into the poor outcome group (n=26) and the good outcome group (n=54) based on the therapeutic effect after 28 days. General information of the patients was collected, and the counts of peripheral blood T lymphocyte subsets (CD3⁺, CD4⁺, CD8⁺) were detected. The predictive value of peripheral blood T lymphocyte subsets for poor short-term in-hospital outcomes in elderly patients with severe pneumonia was analyzed by receiver operating characteristic (ROC) curve; the risk factors for poor short-term in-hospital outcomes in elderly patients with severe pneumonia were analyzed by multivariate Logistic regression. 【Results】Compared with the good outcome group, the poor outcome group had a higher proportion of patients with an APACHE Ⅱ score > 25 and pleural effusion (P<0.05), and lower counts of peripheral blood CD3⁺, CD4⁺, and CD8⁺ cells (P<0.05). The ROC curve analysis results showed that the area under the curve (AUC) of CD3⁺, CD4⁺, and CD8⁺ for predicting poor short-term in-hospital outcomes in elderly patients with severe pneumonia was 0.775, 0.757, and 0.889, respectively (all P<0.05). The multivariate Logistic regression analysis results showed that APACHE Ⅱ score >25 points, pleural effusion, CD3⁺ ≤ 772.195 cells/μL, CD4⁺ ≤ 364.506 cells/μL, and CD8⁺ ≤ 338.052 cells/μL were risk factors for poor short-term in-hospital outcomes in elderly patients with severe pneumonia (P<0.05). 【Conclusion】Poor short-term in-hospital outcomes in elderly patients with severe pneumonia may be related to a higher APACHE Ⅱ score and the presence of pleural effusion. In addition, the counts of peripheral blood CD3⁺, CD4⁺, and CD8⁺ in patients with poor outcomes were lower, and these indicators can be used as reference indicators for evaluating and predicting poor in-hospital outcomes in elderly patients with severe pneumonia.

Key words： Pneumonia Critical Illness T-Lymphocyte Subsets Prognosis

收稿日期: 2024-12-12

中图分类号:

R563.1

基金资助:* 福建省省级临床重点专科建设项目(编号:20230104)

引用本文:

吕骁, 张宏英, 潘建光. 外周血T淋巴细胞亚群对老年重症肺炎患者短期院内转归的预测价值^*[J]. 医学临床研究, 2025, 42(10): 1700-1703.
LYU Xiao, ZHANG Hongying, PAN Jianguang. Value of T Lymphocyte Subsets in Predicting Short-Term Outcomes in Elderly Patients with Severe Pneumonia. JOURNAL OF CLINICAL RESEARCH, 2025, 42(10): 1700-1703.

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http://journal07.magtech.org.cn/yxlcyj/CN/10.3969/j.issn.1671-7171.2025.10.006 或 http://journal07.magtech.org.cn/yxlcyj/CN/Y2025/V42/I10/1700

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