2019 年第 7 期 第 14 卷

外周血双阴性T淋巴细胞在支气管扩张合并感染患者中的变化及意义

Changes and significance of peripheral blood double-negative T lymphocytes in patients with bronchiectasis and infection

作者：李天水张平骥綦颖刘法永夏国光戴丽

英文作者：

单位：100035北京积水潭医院呼吸与危重症医学科

英文单位：

关键词：支气管扩张；急性加重；双阴性T淋巴细胞

英文关键词：

• 摘要：

• 【摘要】目的    探讨支气管扩张合并感染患者外周血中双阴性T淋巴细胞（DNT）的变化及意义。方法    收集2016年1月至2018年1月在北京积水潭医院因支气管扩张住院的113例患者的临床资料（支扩组），经过年龄、性别、并发症匹配，收集同期住院的非支气管扩张116例患者的临床资料（对照组）。比较2组患者年龄、性别、合并症、淋巴细胞计数（L）、总T淋巴细胞（CD+3%）、CD+3CD+4T淋巴细胞（CD+4%）、CD+3CD+8T淋巴细胞（CD+8%）、CD+4/CD+8比值、DNT、免疫球蛋白、近1年急性加重次数、呼吸困难量表（mMRC）评分、动脉血氧分压。结果    2组患者年龄、性别分布和合并冠状动脉粥样硬化性心脏病、高血压、心律失常、糖尿病、心功能不全、睡眠呼吸暂停综合征的比例差异均无统计学意义（均P>0.05）。支扩组L、CD+4/CD+8比值低于对照组，CD+8%、DNT高于对照组［（1.5±0.8）×109/L比（1.9±0.6）×109/L、（1.7±0.9）比（4.0±3.2）、（28±11）%比（24±8）%、（2.4±1.5）%比（1.9±0.9）%］，差异均有统计学意义（均P<0.01）；而CD+3%、CD+4%、免疫球蛋白水平2组间差异均无统计学意义（均P>0.05）。根据DNT将支气管扩张患者分为DNT>6.7%组、DNT 2.1%～6.7%组、DNT<2.1%组，进行临床指标的比较，结果显示3组间近1年急性加重次数、mMRC评分、动脉血氧分压差异均无统计学意义（均P>0.05）。结论    支气管扩张合并感染患者外周血DNT数量增高，DNT可能参与了支气管扩张合并感染的发病过程。

• 【Abstract】Objective    To analyze the changes and significance of peripheral blood double-negative T lymphocytes(DNT) in patients with bronchiectasis complicated with infection. Methods    Clinical data of 113 bronchiectasis patients(bronchiectasis group) and 116 patients without bronchiectasis matched for age, sex and complications(control group) hospitalized in Beijing Jishuitan Hospital from January 2016 to January 2018 and were collected. Age, sex, comorbidities, lymphocyte count(L), total T lymphocyte(CD+3%), CD+3CD+4T lymphocyte(CD+4%), CD+3CD+8T lymphocyte(CD+8%), CD+4/CD+8, DNT, immunoglobulin, frequency of acute exacerbation in the past year, score of mMRC dyspnea scale and arterial partial pressure of oxygen were analyzed. Results    There were no significant differences in age, sex, coronary heart disease, hypertension, arrhythmia, diabetes, cardiac insufficiency and sleep apnea syndrome between groups(all P>0.05). L and CD+4/CD+8 in bronchiectasis group were significantly lower while CD+8% and DNT were higher than those in control group［（1.5±0.8）×109/L vs （1.9±0.6）×109/L, （1.7±0.9） vs （4.0±3.2）, （28±11）% vs （24±8）%, （2.4±1.5）% vs （1.9±0.9）%］(all P<0.01). There were no significant differences of CD+3%, CD+4% and immunoglobulin level between groups(all P>0.05). Bronchiectasis patients were divided into three groups: DNT<2.1%, DNT 2.1%-6.7% and DNT>6.7%; frequency of acute exacerbation in the past year, mMRC score and arterial partial pressure of oxygen showed no significant difference among the 3 groups(all P>0.05). Conclusion    Increased DNT in peripheral blood may be involved in the pathogenesis of bronchiectasis with infection.