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病毒性肺炎患者淋巴细胞亚群、IL-6水平及其与预后的关系

Lymphocyte subpopulations and interleukin-6 levels in patients with viral pneumonia and their relationship with prognosis

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目的 探讨病毒性肺炎患者外周血淋巴细胞亚群、IL-6水平及其与预后的关系.方法 选取2021年12月至2023年11月清华大学附属垂杨柳医院急诊收治的100例病毒性肺炎患者,分为存活组和死亡组,选取20例同期的健康体检者为健康对照组,收集患者的一般资料,检测患者外周血淋巴细胞亚群及相关细胞因子IL-6,分析不同组外周血淋巴细胞亚群水平及IL-6之间的差异,并采用多因素logistic回归分析病毒性肺炎患病和死亡的影响因素.结果 死亡组合并糖尿病比例明显高于存活组(P<0.05).合并糖尿病的患者病死率高于未合并糖尿病者[60.7%(17/28)vs 12.5%(9/72),P<0.05].病毒性肺炎患者外周血T淋巴细胞总数、辅助/诱导性T淋巴细胞(Th)、CD4+/CD8+比值、B淋巴细胞数、自然杀伤(NK)细胞均显著低于健康对照组(均P<0.05),IL-6水平显著高于健康对照组(P<0.05);死亡组患者外周血T淋巴细胞总数、Th细胞、CD4+/CD8+比值、B淋巴细胞数、NK细胞明显低于存活组(均P<0.05),IL-6水平显著高于存活组(P<0.05).多因素logistic回归分析结果显示,T淋巴细胞各亚群及IL-6均为病毒性肺炎患病和死亡的影响因素(均P<0.05).结论 病毒性肺炎患者合并糖尿病时病死率增加;病毒性肺炎患者淋巴细胞各亚群绝对数减少、IL-6水平升高;死亡组和存活组相比,变化差异更明显;早期测定外周血淋巴细胞亚群及IL-6水平有利于评估病毒性肺炎患者预后,对临床有一定指导价值.
Objective To explore the relationship between peripheral blood lymphocyte subsets,interleukin-6(IL-6)levels,and prognosis in patients with viral pneumonia.Methods A total of 100 patients with viral pneumonia admitted to the Emergency Department of the Chuiyangliu Hospital Affiliated to Tsinghua University from December 2021 to November 2023 were selected and divided into a survival group and a death group.20 healthy individuals who underwent physical examinations during the same period were selected as the control group.General information of the patients was collected,and peripheral blood lymphocyte subsets and related cytokine IL-6 were detected.Differences in peripheral blood lymphocyte subsets and IL-6 levels among different groups were analyzed,And multiple logistic regression was used to analyze the influencing factors of viral pneumonia disease and death.Results The proportion of death group with diabetes was significantly higher than that of survival group(P<0.05).The mortality of patients with diabetes was higher than that of patients without diabetes[60.7%(17/28)vs 12.5%(9/72),P<0.05].The total number of peripheral blood T lymphocytes,helper/inducible T lymphocytes(Th),CD4+/CD8+ratio,B lymphocyte count,and natural killer(NK)cells in patients with viral pneumonia were significantly lower than those in the healthy control group(all P<0.05),and the level of IL-6 was significantly higher than that in the healthy control group(P<0.05);The total number of peripheral blood T lymphocytes,Th cells,CD4+/CD8+ratio,B lymphocyte count,and NK cells in the death group were significantly lower than those in the survival group(all P<0.05),and the level of IL-6 was significantly higher than that in the survival group(P<0.05).The results of multivariate logistic regression analysis showed that T lymphocyte subsets and IL-6 were all influencing factors for the disease and death of viral pneumonia(all P<0.05).Conclusions The mortality of viral pneumonia patients with diabetes increased;The absolute number of lymphocyte subsets decreases and the level of IL6 increases in patients with viral pneumonia;The difference in changes between the death group and the survival group is more significant;Early detection of peripheral blood lymphocyte subsets and IL6 levels is beneficial for evaluating the prognosis of patients with viral pneumonia and has certain guiding value for clinical practice.

Pneumonia,viralLymphocyte subsetsInterleukin-6

钟洁、潘兴邦、顾伟

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清华大学附属垂杨柳医院急诊科,北京 100023

肺炎,病毒性 淋巴细胞亚群 白细胞介素6

北京市临床重点专科培育项目(2023)

2024

中国医师杂志
中华医学会 湖南省医学会

中国医师杂志

CSTPCD
影响因子:0.876
ISSN:1008-1372
年,卷(期):2024.26(2)
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