|
|
|
| Value of T Lymphocyte Subsets in Predicting Short-Term Outcomes in Elderly Patients with Severe Pneumonia |
| LYU Xiao, ZHANG Hongying, PAN Jianguang |
| Department of Respiration,Fuzhou Pulmonary Hospital of Fujian, Fujian Fuzhou 350008 |
|
|
|
|
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.
|
|
Received: 12 December 2024
|
|
|
|
|
|
[1] SONG Y, SUN W X, DAI D Y, et al. Prediction value of procalcitonin combining CURB-65 for 90-day mortality in community-acquired pneumonia[J].Expert Rev Respir Med,2021,15(5):689-696.
[2] 陈劲松,王丽娜.老年SAP患者外周血T淋巴细胞亚群、血清PCT及hs-CRP水平变化的临床探析[J].临床输血与检验,2019,21(2):187-190.
[3] 丁志明.肺炎支原体感染患者外周血T细胞亚群血清免疫球蛋白与患者病情的相关性研究[J].中国药物与临床,2021,21(4):561-564.
[4] 中华医学会呼吸病学分会.中国成人社区获得性肺炎诊断和治疗指南(2016年版)[J].中华结核和呼吸杂志,2016,39(4):253-279.
[5] 余让辉,陈辉,柳晓峰,等.基于流行病学与临床资料调查的重症肺炎患者预后影响因素研究[J].解放军预防医学杂志,2020,38(2):88-90.
[6] 于乃浩,褚玉茹,刘娜娜,等.CD3+T淋巴细胞计数联合早期预警评分对重症肺炎患者28 d死亡风险的预测价值[J].中国现代医学杂志,2023,33(2):72-77.
[7] 余燕娟,张向峰,张小宁,等.不同病程时期支原体肺炎患儿的外周血T淋巴细胞亚群、免疫球蛋白及细胞因子的动态变化分析[J].中国临床实用医学,2021,12(2):39-42.
[8] 褚旭丽,吴玲玲,李雁.肺炎支原体感染对患儿外周血T淋巴细胞亚群及肺功能的影响[J].中国妇幼保健,2021,36(3):596-598.
[9] 周明英,周丽珍,陈翠丽,等.老年重症肺炎合并急性呼吸衰竭患者的转归及影响因素分析[J].中国临床保健杂志,2023,26(5):699-701.
[10] 孙静静,王长强,冉宇.老年重症肺炎合并脓毒性休克病人预后影响因素分析[J].实用老年医学,2020,34(5):439-442.
[11] 王凡,陈旭昕,韩志海.重症肺炎早期患者外周血T淋巴细胞亚群比例变化及预后预测效能[J].山东医药,2021,61(27):32-36.
[12] 谢紫阳,赵光宇,田恬.外周血淋巴细胞亚群及血清细胞因子水平与大叶性肺炎患儿预后及转归的相关性[J].临床和实验医学杂志,2021,20(18):1994-1998.
[13] 包榕,陈碧,王海清,等.外周血T淋巴细胞亚群计数、APACHEⅡ对成人社区获得性肺炎短期预后的临床价值[J].医学研究杂志,2022,51(4):99-103.
[14] 张黎蕾,夏永泉,王贤,等.重症肺炎患者炎症指标、免疫功能及凝血功能变化对预后的影响[J].南京医科大学学报(自然科学版),2021,41(2):234-237. |
|
|
|
2025, Vol. 42 
