目的 探讨T淋巴细胞亚群变化在脑卒中相关性肺炎预测中的价值及准确性.方法 采用流式细胞术对80例病例(疾病:脑卒中,时间:2022年12月至2023年11月)进行检测,根据其住院后1周是否发生相关肺炎分为肺炎组、非肺炎组,采集患者外周静脉血进行T淋巴细胞亚群变化检测,对比不同人群者T淋巴细胞亚群变化及T淋巴细胞亚群在脑卒中相关性肺炎预测中的价值.结果 按照美国国立卫生研究院卒中量表(National Institute of Health stroke scale,NIHSS)评分对80例脑卒中患者分级,轻症组NIHSS评分＜10分(n=45)、重症组NIHSS评分≥10分(n=35).轻症组CD3+、CD4+、CD4+/CD8+高于重症组,CD8+低于重症组(P＜0.05);住院后1周通过检测发现22例出现相关性肺炎,经对比发现肺炎组CD3+、CD4+、CD4+/CD8+低于非肺炎组,CD8+高于非肺炎组(P＜0.05);以实验室检查结果为金标准,CD3+、CD4+、CD8+、CD4+/CD8+单一诊断脑卒中相关性肺炎准确率低于T淋巴细胞亚群联合诊断准确率(P＜0.05);经Pearson相关性分析发现CD3+、CD4+、CD4+/CD8+与NIHSS评分呈负相关,CD8+与NIHSS评分呈正相关.结论 在脑卒中相关性肺炎预测中应用T淋巴细胞变化不仅可评估患者神经损伤程度,亦可对其是否发生相关性肺炎进行预测,为临床医师及早干预提供参考,值得借鉴与学习.
An Evaluation of the Accuracy of Predicting Stroke Associated Pneumonia by Using Changes in T Lymphocyte Subsets
Objective To explore the value and accuracy of changes in T lymphocyte subsets in predicting stroke associated pneumonia.Methods Stroke were detected among 80 cases using flow cytometry during February 2022 to January 2023.These patients were then divided into a pneumonia group and non-pneumonia group based on whether they developed related pneumonia one week after hospitalization.Peripheral venous blood samples were collected from all patients for T lymphocyte subsets change detection,and the value of T lymphocyte subsets in predicting stroke related pneumonia in different populations was compared and evaluated.Results According to the National Institute of Health Stroke Scale(NIHSS)score,80 stroke patients were graded,with a mild group having a NIHSS score of＜10 points(n=45)and a severe group having a NIHSS score of ≥10 points(n=35).Levels of CD3+,CD4+,CD4+/CD8+in the mild group were significantly higher than those in the severe group,while CD8+was significantly lower than that in the severe group(P＜0.05);After one week of hospitalization,22 cases were found to have associated pneumonia through testing.With comparison study,we found that CD3+,CD4+,CD4+/CD8+in the pneumonia group were significantly lower than those in the non-pneumonia group,while CD8+was significantly higher than that in the non-pneumonia group(P＜0.05);Using laboratory test results as the gold standard,the accuracy of single diagnosis of stroke associated pneumonia with CD3+,CD4+,CD8+,and CD4+/CD8+was lower than that of combined diagnosis of T lymphocyte subsets(P＜0.05);Pearson correlation analysis showed that CD3+,CD4+,CD4+/CD8+were negatively correlated with NIHSS score,while CD8+was positively correlated with NIHSS score.Conclusion The application of T lymphocyte changes in the prediction of stroke associated pneumonia can not only evaluate the degree of neurological damage in patients,but also predict whether related pneumonia will occur.This can provide useful reference for the early intervention for physicians and is worth of clinical applications.
T lymphocyte subsetsPredictionStrokeAssociated pneumoniaAccuracyDegree of nerve damage
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