老年急性呼吸窘迫综合征病人早期免疫细胞动态变化与肺部感染的相关性研究

doi:10.3969/j.issn.1003-9198.2025.03.011

Abstract

Abstract: Objective To explore the correlation between early immune cell dynamics and pulmonary infection in the elderly patients with acute respiratory distress syndrome(ARDS). Methods A total of 113 elderly patients with ARDS who were hospitalized in General Hospital of the Western Theater Command of Chinese PLA from January 2021 to January 2024 were enrolled in this study. They were divided into the infected group(49 cases) and the uninfected group(64 cases) based on whether they presented with pulmonary infection. The general information and early immune cell dynamics between the two groups were compared. Multivariate Logistic regression was used to analyze the effect of early dynamic changes of immune cells on the severity of pulmonary infection in the elderly patients with ARDS. Restricted cubic spline model was used to analyze the dose-response relationship between early immune cell dynamics and lung infection. Results There were statistically significant differences in the levels of C-reactive protein(CRP), procalcitonin(PCT) and white blood cell(WBC) between the two groups(P<0.05). Compared with the uninfected group, the level of CD3⁺ T cells was significantly increased and the levels of CD4⁺, CD8⁺ T cells and CD4⁺/CD8⁺ ratio were significantly decreased in the infected group 6 h, 2 d and 3 d after admission(P<0.05). Ordinal logistic regression analysis showed that the changes of CD4⁺, CD8⁺ T cells and CD4⁺/CD8⁺ had a certain effect on the degree of pulmonary infection in the elderly patients with ARDS(P<0.05). The correlation of CD3⁺, CD4⁺, CD8⁺cell levels and CD4⁺/CD8⁺ 6 h after admission with pulmonary infection in the elderly ARDS patients showed a non-linear dose-response relationship(P_{non-linearity}=0.411, 0.516, 0.439, 0.402). Conclusions The early dynamic changes of immune cells in the elderly ARDS patients are closely related to pulmonary infection, and it has a certain effect on the degree of pulmonary infection.

Key words: aged, acute respiratory distress syndrome, immune cells, pulmonary infection

CLC Number:

R 563.8

LI Guoyuan, LIU Changying, HAO Xiaodan, CHENG Hui, YUAN Shuxuan, CHEN Jieyu, WANG Zhang. Correlation between early dynamic changes of immune cells and pulmonary infection in elderly patients with acute respiratory distress syndrome[J]. Practical Geriatrics, 2025, 39(3): 263-267.

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Correlation between early dynamic changes of immune cells and pulmonary infection in elderly patients with acute respiratory distress syndrome

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