摘要
目的分析淋巴T细胞亚群水平与支气管哮喘患者肺功能相关性及两者对患者预后的影响。方法采取回顾性研究,选择2021年11月至2023年6月郑州市第二人民医院收治的80例支气管哮喘患者临床资料作为研究对象。采用哮喘控制量表(CAT)评估患者预后情况,总分<24分为未完全控制,总分≥24分为完全控制,将总分<24分患者临床资料纳入预后不良组(29例),将总分≥24分患者临床资料纳入预后良好组(51例)。患者入院时均检测淋巴T细胞亚群水平及肺功能,统计患者基线资料。采用双变量相关性Pearson(N)分析淋巴T细胞亚群水平与支气管哮喘患者肺功能的相关性;采用二元Logistic回归分析淋巴T细胞亚群水平、肺功能与支气管哮喘患者预后的关系;采用接受者操作特性曲线(ROC)分析淋巴T细胞亚群水平对支气管哮喘患者预后不良的预测价值。结果治疗后,CD3^(+)、CD4^(+)低于治疗前,CD8^(+)高于治疗前,差异有统计学意义(P<0.05);采用双变量相关性Pearson(N)分析显示,CD3^(+)、CD4^(+)与FEV1、FVC、FEV1/FVC呈负相关,差异有统计学意义(r<0,P<0.05),CD8^(+)与FEV1、FVC、FEV1/FVC呈正相关,差异有统计学意义(r>0,P<0.05);预后不良组家族哮喘史、吸烟史患者占比高于预后良好组,FEV1、FVC、FEV1/FVC、CD8^(+)低于预后良好组,CD3^(+)、CD4^(+)高于预后良好组,差异有统计学意义(P<0.05);二元Logistic回归分析结果显示,吸烟史、FVC、CD3^(+)、CD4^(+)高水平是支气管哮喘患者预后不良的危险因素,差异有统计学意义(OR>1,P<0.05),CD8^(+)高水平是支气管哮喘患者预后不良的保护因素,差异有统计学意义(OR<1,P<0.05);绘制ROC曲线结果显示,CD3^(+)、CD4^(+)、CD8^(+)水平及联合检测预测支气管哮喘患者预后情况的AUC均>0.70,有一定预测价值,其中联合检测最高。结论淋巴T细胞亚群水平与支气管哮喘患者肺功能关系密切,同时两者还可影响患者预后,淋巴T细胞各亚群水平联合检测能够有效预测患者预后不良风险。
Objective To analyze the correlation between the level of lymphoid T cell subsets and lung function in patients with bronchial asthma and their effects on the prognosis of patients.Methods A retrospective study was conducted to select the clinical data of 80 patients with bronchial asthma admitted to the hospital from November 2021 to June 2023 as the study subjects.The asthma control scale(CAT)was used to evaluate the prognosis of patients.The total score<24 was divided into incomplete control,and the total score≥24 was divided into complete control.The clinical data of patients with total score<24 were included in the poor prognosis group(29 cases),and the clinical data of patients with total score≥24 were included in the good prognosis group(51 cases).The levels of lymphocyte T cell subsets and lung function were detected on admission,and the baseline data of the patients were counted.Bivariate correlation Pearson(N)analysis showed that the level of lymphoid T cell subsets was correlated with lung function in patients with bronchial asthma.Binary Logistic regression was used to analyze the relationship between the level of T lymphocyte subsets,lung function and the prognosis of patients with bronchial asthma.Receiver operating characteristic curve(ROC)was used to analyze the predictive value of lymphocyte T cell subsets for poor prognosis in patients with bronchial asthma.Results After treatment,CD3^(+)and CD4^(+)were lower than those before treatment,and CD8^(+)was higher than that before treatment,with a statistically significant difference(P<0.05).Pearson(N)analysis showed that CD3^(+)and CD4^(+)were negatively correlated with FEV1,FVC and FEV1/FVC,with a statistically significant difference(r<0,P<0.05),and CD8^(+)was positively correlated with FEV1,FVC and FEV1/FVC,with a statistically significant difference(r>0,P<0.05);The proportion of patients with family history of asthma and smoking history in the poor prognosis group was higher than that in the good prognosis group,FEV1,FVC,FEV1/FVC and CD8^(+)were lower than those in the good prognosis group,CD3^(+)and CD4^(+)were higher than those in the good prognosis group;Binary Logistic regression analysis showed that smoking history,high levels of FVC,CD3^(+)and CD4^(+)were risk factors for poor prognosis in patients with bronchial asthma,with a statistically significant difference(OR>1,P<0.05).The high level of CD8^(+)was a protective factor for the poor prognosis of patients with bronchial asthma,with a statistically significant difference(OR<1,P<0.05);TheResults of drawing ROC curve showed that the levels of CD3^(+),CD4^(+),CD8^(+),and the AUC of combined detection for predicting the prognosis of bronchial asthma patients are all greater than 0.70,which had certain predictive value,and the combined detection was the highest.Conclusion The level of lymphatic T cell subsets is closely related to the lung function of patients with bronchial asthma,and the two can also affect the prognosis of patients.Combined detection of various subpopulations of lymphoid T cells can effectively predict the risk of poor prognosis in patients.
作者
刘正
LIU Zheng(Department of Respiratory and Critical Care Medicine,Zhengzhou Second People’s Hospital,Zhengzhou Henan 450000,China)
出处
《临床研究》
2023年第12期12-16,共5页
Clinical Research
关键词
支气管哮喘
淋巴T细胞亚群
肺功能
预后
相关性
bronchial asthma
lymphatic T cell subsets
lung function
prognosis
correlation
