老年亚急性咳嗽病人辅助性T细胞亚群分布特征及其与气道高反应性的相关性分析

doi:10.3969/j.issn.1003-9198.2024.10.020

摘要/Abstract

摘要： 目的探讨老年亚急性咳嗽病人辅助性T淋巴细胞亚群的分布特征以及与气道高反应性程度的相关性。方法选取2021年6月至2023年6月于中国人民解放军西部战区总医院诊治的201例老年亚急性咳嗽病人,按照气道高反应性分级将病人分为轻度气道高反应性组(n=94)和重度气道高反应性组(n=107)。比较2组受试者的一般资料及生化资料;采用多因素Logistic回归分析影响老年亚急性咳嗽病人发生重度气道高反应性的危险因素;构建广义线性混合效应模型(GLMMs)分析辅助性T细胞亚群水平与气道高反应性程度的关系。结果 2组在年龄、性别、咽喉瘙痒、反复呼吸道感染、鼻炎、气管异物,CD3⁺、CD4⁺、CD8⁺T淋巴细胞,FVC、FEV1、FEV1/FVC、IL-25、IL-33、呼出气一氧化氮(FENO)方面差异有统计学意义(P<0.05)。Logistic回归分析显示,反复呼吸道感染、CD3⁺和CD4⁺T淋巴细胞水平降低及CD8⁺T淋巴细胞、FEV1、IL-25、IL-33、FENO水平升高是老年亚急性咳嗽病人重度气道高反应性的危险因素(P< 0.05)。GLMMs分析结果显示,CD3⁺、CD4⁺T淋巴细胞水平越低和CD8⁺T淋巴细胞水平越高,老年亚急性咳嗽病人并发气道高反应性风险越大(P<0.05)。结论老年亚急性咳嗽重度气道高反应病人外周血CD3⁺、CD4⁺T淋巴细胞百分比低于轻度气道高反应性病人,CD8⁺T淋巴细胞百分比高于轻度气道高反应性病人,且CD3⁺、CD4⁺、CD8⁺T淋巴细胞水平与气道高反应性程度存在相关性。

关键词: 亚急性咳嗽, 老年人, 气道高反应性, 辅助性T淋巴细胞, 相关性分析

Abstract: Objective To investigate the distribution characteristics of helper T lymphocyte subsets in the elderly patients with subacute cough and the correlation with airway hyperresponsiveness. Methods A total of 201 elderly patients with subacute cough treated in the General Hospital of Western Theater Command PLA from June 2021 to June 2023 were enrolled in this study. According to the grade of airway hyperresponsiveness, the patients were divided into mild airway hyperresponsiveness group (n=94) and severe airway hyperresponsiveness group (n=107). The general data and biochemical data of the two groups were compared. Multivariate Logistic regression analysis was used to analyze the risk factors for the degree of airway hyperresponsiveness in the elderly patients with subacute cough. Generalized linear mixed models (GLMMs) was used to analyze the relationships between the levels of T helper cell subsets and the degree of airway hyperresponsiveness in the elderly patients with subacute cough. Results There were significant differences in age, gender, laryngeal pruritis, recurrent respiratory tract infection, rhinitis, tracheal foreign body, CD3⁺, CD4⁺ and CD8⁺T lymphocytes, forced vital capacity (FVC), forced expiratory volume in one second (FEV1), FEV1/FVC, interleukin-25 (IL-25), IL-33 and fractional exhaled nitric oxide (FENO) between the two groups (P<0.05). Logistic regression analysis showed that recurrent respiratory infections, decreased levels of CD3⁺ and CD4⁺ T lymphocytes, and increased levels of CD8⁺ T lymphocytes, FEV1, IL-25, IL-33, and FENO were the risk factors for severe airway hyperreactivity hyperresponsiveness in the elderly patients with subacute cough (P<0.05). GLMMs analysis showed that the lower levels of CD3⁺ and CD4⁺ T lymphocytes and the higher levels of CD8⁺ T lymphocytes, the greater risk of aircoay hyperresponsiveness in the elderly patients with subacute couth(P<0.01). Conclusions The levels of peripheral blood CD3⁺ and CD4⁺ T lymphocytes are lower and the level of CD8⁺ T lymphocytes is higher in the patients with severe airway hyperresponsiveness than those in the patients with mild airway hyperresponsiveness, and the levels of CD3⁺, CD4⁺ and CD8⁺ T lymphocytes are correlated with the degree of airway hyperresponsiveness in the elderly patients with subacute cough.

Key words: subacute cough, aged, airway hyperresponsiveness, helper T lymphocytes, correlation analysis

中图分类号:

R 441.5

何慧琼, 吴希, 张一洁, 陈真敏, 汤小娟. 老年亚急性咳嗽病人辅助性T细胞亚群分布特征及其与气道高反应性的相关性分析[J]. 实用老年医学, 2024, 38(10): 1059-1063.

HE Huiqiong, WU Xi, ZHANG Yijie, CHEN Zhenmin, TANG Xiaojuan. Distribution characteristics of helper T cell subsets and its correlation with airway hyperrespon-siveness in elderly patients with subacute cough[J]. Practical Geriatrics, 2024, 38(10): 1059-1063.

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