不同预后的重症肺炎患者住院期间血清和肺泡灌洗液TLR4水平、外周血免疫细胞计数比较

发布时间：2019-04-03 19:23

【摘要】：目的观察比较不同预后的重症肺炎患者住院期间血清和肺泡灌洗液Toll样受体4(TLR4)水平、外周血免疫细胞计数[CD3~+ T、CD4~+ T、CD8~+ T、CD19+%、T淋巴细胞+B淋巴细胞+NK细胞计数(T+B+NK计数)]。方法内科ICU住院治疗的重症肺炎患者43例,根据住院28 d内的转归(存活或死亡)将患者分为生存组25例、死亡组18例。分别于入院第1、7天采用ELISA法检测血清及肺泡灌洗液中的TLR4,采用流式细胞仪检测外周血CD3~+ T、CD4~+ T、CD8~+ T、T+B+NK计数、CD19+%。结果死亡组入院第7天血清、肺泡灌洗液中TLR4水平高于生存组(P均0.05)。死亡组入院第1天CD19+%高于生存组,入院第7天CD3~+ T、CD4~+ T、CD8~+ T计数及CD19+%低于生存组(P均0.05)。结论入院28 d内死亡的重症肺炎患者较生存患者TLR4水平升高,CD3~+ T、CD4~+ T、CD8~+ T计数及CD19+%下降;TLR4水平升高和免疫功能下降的重症肺炎患者预后不良。
[Abstract]:Objective to observe and compare the serum and alveolar lavage fluid Toll-like receptor 4 (TLR4) levels, peripheral blood immune cell count [CD3~ T, CD 4 ~ T, CD 8 ~ T, CD 19%] in patients with severe pneumonia with different prognosis during hospitalization. T lymphocyte B lymphocyte NK cell count (T B NK count]. Methods 43 patients with severe pneumonia were divided into survival group (25 cases) and death group (18 cases) according to the outcome (survival or death) of ICU in internal medicine. TLR4, in serum and bronchoalveolar lavage fluid was detected by ELISA on the 1st and 7th day after admission. CD3~ T, CD4 ~ T, CD _ 8 ~ T, T B NK count and CD19% in peripheral blood were detected by flow cytometry. Results the levels of TLR4 in serum and alveolar lavage fluid in the death group were higher than those in the survival group on the 7th day after admission (all P 0.05). On the 1st day of admission, the CD19% in the death group was higher than that in the survival group. The counts of CD3~ T, CD 4 ~ T, CD 8 ~ T and CD19% on the 7th day of admission in the death group were lower than those in the survival group (P 0.05). Conclusion the levels of TLR4, CD3~ T, CD 4 ~ T, CD 8 ~ T and CD19% in severe pneumonia patients who died within 28 days after admission were higher than those in survival patients, and the prognosis of severe pneumonia patients with higher TLR4 level and lower immune function was poor.
【作者单位】：贵州大学医学院;贵州省人民医院;贵州省呼吸疾病研究所;贵州医科大学附属医院;
【基金】：贵阳市科技合作计划资助项目(2011103)
【分类号】：R563.1

【相似文献】