The Clinical Research On T Lymphocyte Subsets In Patients With Severe Bacterial Pneumonia

Objective:To investigate the local and overall immune status on patients with severe bacterial pneumonia by analyzing the T lymphocyte subsets of bronchoalveolar lavage fluid(BALF)and peripheral blood and the clinical value of T lymphocyte subsets in predicting severe pneumonia combined with PCT,PSI scores.Methods :The research consisted hospitalized patients with confirmed community acquired bacterial pneumonia and divided them into Group NSP/SP and Group low-risk/medium-risk/high-risk based on PSI.Compared the difference of BALF and peripheral blood T lymphocyte subsets(CD3+?CD4+?CD8+)level? clinical features?WBC?PCT among groups.Diagramming the ROC curve to investigate the usefulness of peripheral blood T lymphocyte subsets in predicting severe pneumonia.Results:About 63 CAP patients in the research,Group SP 17 cases and Group NSP 46 cases.The results showed that in Group SP,BALF CD4 +%,CD4 + / CD8 + were decreased,the CD8 + % were increased,and the Neutrophils(Neu)% were significantly increased;for the peripheral blood T lymphocyte subsets,CD3 +% ?CD4 + % in Group SP fell without statistical difference,CD8 +% and CD4 + / CD8 +rose without statistical difference as well,the absolute value of CD3 +?CD4 + ?CD8+ in Group NP fell remarkably.Age,PCT,the WBC and PSI Score,the proportion of cancer,heart disease,cerebral infarction,liver disease in Group SP were significantly higher.Among the group low-risk/medium-risk/high-risk,CD3 +%?CD4 +% ?CD8+%?CD4 + / CD8+ had no statistical difference,however,the absolute value of CD3+?CD4 +? CD8 + increased with the severity of PSI Score and CD3 +?CD4 +having statistically significance.The correlation on the CD3+absolute value?PCT with PSI Score were strongest in the Group high-risk and the value of CD3 + absolute value for prediction SP was medium(AUC = 0.895,P < 0.895).Conclusion:SP patients had disordered and suppressive immune status not only in the local lung tissue but also for the whole.Age,cancer,heart disease,cerebral infarction,liver disease might be the important factors,as well as the excessive inflammatory reaction.Peripheral blood T lymphocyte subsets could be used to predict SP,the application of percentage was less useful than the absolute value.