T淋巴细胞亚群对成人社区获得性肺炎的评估价值

Evaluation Value of T Lymphocyte Subsets of Community-Acquired Pneumonia in Adults

摘要: 目的：探讨外周血T淋巴细胞对成人社区获得性肺炎(community-acquired pneumonia, CAP)评估病情严重程度及预后的检测价值。方法：回顾性收集2022年12月至2023年2月本院收治的82例社区获得性肺炎患者，按病情分为非重症组肺炎42例，重症组肺炎40例。入院时行血常规分析及T淋巴细胞亚群检测，并进行比较。结果：重症组与非重症组患者的基线资料(年龄、性别)无统计学差异意义(P > 0.05)。外周血中重症肺炎组淋巴细胞计数明显低于非重症组(P < 0.05)。重症肺炎组CD3+T淋巴计数与CD4+T淋巴细胞计数均低于非重症组(P < 0.05)，CD8+T淋巴细胞计数差异无统计学意义(P > 0.05)。绘制ROC曲线，CD4+T淋巴细胞计数预测重症肺炎的ROC曲线下面积(AUC)为0.787，阈值为228个/ul，敏感度为81%，特异度为70%。结论：T淋巴细胞对CAP病情监测、治疗指导有临床意义，动态监测T淋巴细胞亚群水平变化可对评估病情的严重程度及预后有指导作用。

Abstract: Objective: To investigate the detection value of peripheral blood T lymphocytes in assessing the se-verity and prognosis of community-acquired pneumonia (CAP) in adults. Methods: A retrospective collection of 82 patients with community-acquired pneumonia admitted to our hospital from De-cember 2022 to February 2023. Patients were divided into 42 cases of non-severe pneumonia group and 40 cases of severe pneumonia group. Blood routine and T lymphocyte subsets were per-formed on admission and compared. Results: There was no significant difference in baseline data (age and sex) between the severe group and the non-severe group (P > 0.05). The lymphocyte count of severe pneumonia group in peripheral blood was significantly lower than that in the non-severe group (P < 0.05). CD3+T lymphocyte count and CD4+T lymphocyte count were lower than in the non-severe group (P < 0.05) in the severe pneumonia group, and there was no significant difference in CD8+T lymphocyte count (P > 0.05). The ROC curve showed that the area under the ROC curve (AUC) of CD4+T lymphocyte count for predicting severe pneumonia was 0.787, the threshold was 228 cells/ul, the sensitivity was 81%, and the specificity was 70%. Conclusion: T lymphocytes have clinical significance for the monitoring and treatment guidance of CAP, and dynamic monitoring of the level of T lymphocyte subsets can guide the assessment of the severity and prognosis of the dis-ease.