T淋巴细胞亚群水平对IPF诊断及预后的评估价值

Value of T lymphocyte subsets in the diagnosis and prognosis with IPF

摘要:

目的分析特发性肺间质纤维化(IPF)患者T淋巴细胞亚群变化及其与预后的关系。 方法选取60例IPF患者作为IPF组,根据随访结果分为预后不良组和预后良好组,另选取30例健康体检者作为对照组。比较各组外周血T淋巴细胞亚群水平,分析IPF患者T淋巴细胞亚群水平与高分辨率计算机断层扫描(HRCT)纤维化评分、肺功能及预后的关系。 结果治疗前,IPF组患者外周血CD8＋水平高于对照组,CD3＋、CD4＋、CD4＋/CD8＋水平低于对照组(P＜0.05)。IPF组患者入院时CD3＋、CD4＋、CD4＋/CD8＋水平与肺功能指标呈正相关,与HRCT评分呈负相关(P＜0.05)；CD8＋水平与肺功能指标呈负相关,与HRCT评分呈正相关(P＜0.05)。预后良好组治疗后外周血CD8＋水平低于预后不良组,CD3＋、CD4＋、CD4＋/CD8＋水平高于预后不良组(P＜0.05)；IPF患者治疗后外周血CD3＋、CD4＋、CD8＋、CD4＋/CD8＋ROC曲线下面积分别为0.732、0.744、0.756、0.796(P＜0.05)。 结论T淋巴细胞亚群水平与IPF患者的预后密切相关,CD8＋高水平,CD3＋、CD4＋低水平可提示其预后不良。

Abstract:

To investigate the value of T lymphocyte subsets in the diagnosis and prognosis with idiopathic pulmonary interstitial fibrosis (IPF). MethodsSity patients with IPF were selected as the IPF group, and divided into poor prognosis group and good prognosis group according to the follow-up results. In addition, 30 healthy subjects were selected as the control group. The levels of peripheral blood T lymphocyte subsets in each group were compared, and the relationship between the levels of T lymphocyte subsets and fibrosis score, pulmonary function and prognosis of patients with IPF were analyzed by high-resolution computed tomography (HRCT). ResultsThe levels of CD8＋ cells in IPF group were higher than those in the control group, while the levels of CD3＋, CD4＋, CD4＋/CD8＋ cells in IPF group were lower than those in the control group (P＜0.05). The levels of CD3＋, CD4＋, CD4＋/CD8＋ cells were positively correlated with pulmonary function index and negatively correlated with HRCT score in the IPF group (P＜0.05), the level of CD8＋ cells was negatively correlated with pulmonary function index, and positively correlated with HRCT score (P＜0.05). The level of peripheral blood CD8＋ cells in good prognosis group was lower than that in the poor prognosis group after treatment, while the levels of CD3＋, CD4＋, CD4＋/CD8＋ cells were higher (P＜0.05). The areas under the ROC curve of peripheral blood CD3＋, CD4＋, CD8＋, CD4＋/CD8＋ in patients with IPF were 0.732,0.744,0.756 and 0.796 respectively (P＜0.05). ConclusionThe level of T lymphocyte subsets is closely related to the prognosis of IPF, the high expression of CD8＋ and the low expression of CD3＋ and CD4＋ may indicate poor prognosis.