慢性心力衰竭合并肺部感染患者T淋巴细胞亚群和免疫球蛋白及基质金属蛋白酶变化分析

陈子安; 陈金强

doi:10.16766/j.cnki.issn.1674-4152.000069

慢性心力衰竭合并肺部感染患者T淋巴细胞亚群和免疫球蛋白及基质金属蛋白酶变化分析

doi: 10.16766/j.cnki.issn.1674-4152.000069

陈子安^,,
陈金强

绍兴市中心医院感染性疾病科, 浙江绍兴 312030

基金项目:

2014年浙江省医药卫生科技计划项目(2014PYA-005)

详细信息

通讯作者:
陈子安,E-mail:694008599@qq.com

中图分类号: R541.6;R563.1
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出版历程
- 收稿日期: 2017-05-11

Changes of T-lymphocyte subsets, immune globulin and matrix metalloproteinase in chronic heart failure patients with pulmonary infection

CHEN Zi-an^,,
CHEN Jin-qiang

Department of Infectious Diseases, Shaoxing Central Hospital, Shaoxing, Zhejiang 312030, China

摘要

摘要: 目的探讨慢性心力衰竭合并肺部感染患者T淋巴细胞亚群、免疫球蛋白(Ig)、基质金属蛋白酶(MMP)变化及预后情况。方法选取2015年9月-2016年12月于绍兴市中心医院进行治疗的慢性心力衰竭患者120例,依据是否合并肺部感染分为感染组和未感染组,其中感染组49例,未感染组71例。观察2组患者血常规指标白细胞计数、中性粒细胞百分比、淋巴细胞百分比,心功能指标脑钠肽(BNP)、左室舒张末容积指数(LVEDVI)、左室收缩末期容积指数(LVESDVI),炎症因子指标白介素6(IL-6)、肿瘤坏死因子α(TNF-α),T淋巴细胞亚群CD4⁺、CD8⁺、CD4⁺/CD8⁺水平,IgA、IgG、IgM水平,MMP-2、MMP-9水平及预后情况,并进行比较。结果感染组患者血常规指标白细胞计数、中性粒细胞百分比、淋巴细胞百分比均明显高于未感染组(P<0.05);感染组患者心功能指标BNP、LVEDVI、LVESDVI均明显高于未感染组(P<0.05),LVEF明显低于未感染组(P<0.05);感染组患者炎症因子指标IL-6、TNF-α水平均明显高于未感染组(P<0.05);2组患者T细胞亚群中CD4⁺水平差异无统计学意义(P>0.05),感染组患者CD8⁺明显高于未感染组(P<0.05),CD4⁺/CD8⁺水平明显低于未感染组(P<0.05);2组患者IgA水平差异无统计学意义(P>0.05),感染组患者IgG、IgM水平均明显低于未感染组(P<0.05);感染组患者MMP-2、MMP-9水平均明显高于未感染组(P<0.05);感染组患者住院时间及病死率均明显高于未感染组(P<0.05)。结论慢性心力衰竭合并肺部感染患者免疫功能低下,MMP水平升高,加重心功能损伤,且其预后较差。
- 慢性心力衰竭 /
- 肺部感染 /
- T淋巴细胞亚群 /
- 免疫球蛋白 /
- 基质金属蛋白酶
Abstract: Objective To investigate the changes of T-lymphocyte subsets, immune globulin (Ig) and matrix metalloproteinase (MMP) in chronic heart failure patients with pulmonary infection and assess the prognosis of patients. Methods A total of 120 chronic heart failure patients in our hospital between September, 2015 and December, 2016 were divided into infection group (n=49) and non-infection group (n=71) according to the condition of pulmonary infection. The levels of white blood cell count, neutrophils percentage, percentage of lymphocytes, cardiac parameters, inflammatory factors, T-lymphocyte subsets, immune globulin and matrix metalloproteinase and prognosis were compared between the two groups. Results The levels of white blood cell count, neutrophils percentage and percentage of lymphocytes of the infection group were significantly higher than those of non-infection group (P<0.05); The levels of BNP, LVEDVI and LVESDVI of lymphocytes of the infection group were significantly higher than those of non-infection group (P<0.05); The levels of IL-6 and TNF-α of the infection group were significantly higher than those of the non-infection group (P<0.05); The level of CD4⁺ had no significant difference between the infection group and non-infection group (P>0.05), the level of CD8+ of the infection group was significantly higher than that of the non-infection group (P<0.05), and the level of CD4⁺/CD8⁺ of the infection group was significantly lower than that of the non-infection group (P<0.05); The level of Ig A had no significant difference between the infection group and non-infection group (P>0.05), and the levels of Ig G and Ig M of the infection group were significantly lower than those of the non-infection group (P<0.05); the levels of MMP-2 and MMP-9 of infection group were significantly higher than those of the non-infection group (P<0.05); the length of hospital stay and mortality of the infection group was significantly higher than that of the non-infection group (P<0.05). Conclusion The chronic heart failure patients with pulmonary infection have low immunity and high level of MMP. The infection will aggravate heart function damage, and lead to a poorer prognosis of patients.
- Chronic heart failure /
- Pulmonary infection /
- T-lymphocyte subsets /
- Immune globulin /
- Matrix metalloproteinase