The Expression And Clinical Significance Of T-Lymphocyte Subsets In Bronchoalveolar Lavage Fluid In Several Types Of Interstitial Lung Disease

Objective: To detect the expression of T-lymphocyte subsets in bronchoalveolar lavage fluid in several types of interstitial lung disease and to evaluate its clinical significance.Methods: 66 patients in the second hospital of Hebei Medical University from December 2015 to December 2017 were enrolled in this study.It could be divided into 43 cases of idiopathic interstitial pneumonia(IIP)group(including 13 case of idiopathic pulmonary fibrosis,2 cases of cryptogenic organizing pneumonia,19 cases of interstitial pneumonia with autoimmune feature,9 cases of other IIP),15 cases of connective tissue disease-interstitial lung disease(CTD-ILD)group(including 8 cases of sjogren syndrome,4cases of rheumatoid arthritis,1 case of systemic sclerosis,2 cases of polymyositis/dermatomyositis),4 cases of granulomatous interstitial lung disease group(including 2 cases of sarcoidosis,2cases of hypersensitivity pneumonitis),4 cases of chronic eosinophilic pneumonia(CEP)group.In this study,the blood gas analysis,lung function,imageology and T-lymphocyte subsets in bronchoalveolar lavage fluid were detected and the correlations between them were explored.Results:1.The percentage of CD8+ T lymphocyte was increased(65.69±13.44%,66.81±13.83%)and CD4/CD8 ratio decreased(0.46±0.25,0.43±0.22)in the IIP and CTD-ILD group and there was no statistical significance(P>0.05).The percentage of CD4+ T lymphocyte and CD4/ CD8 ratio were increased(69.75±10.20%,2.94±1.79)in the granulomatous interstitial lung disease group.The percentage of CD8+ T lymphocyte was increased(54.83±7.87%)in the CEP group.2.The percentage of CD8+ T lymphocyte was increased(64.74±13.09%)in the IPF group,which was negatively correlated with oxygenation index(r=-0.683,P=0.010)and DLCO%/pre(r=-0.818,P=0.004),positively correlated with CT total score(r=0.758,P=0.003).Conclusion:1.There are differences in T-lymphocyte subsets of several types of interstitial lung disease,which can distinguish them to some extent,and it has important clinical value in disease differential diagnosis.2.In the IPF patients,the higher proportion of CD8+ T lymphocyte,the poorer oxygenation index,lung function and imageology,which suggest that higher percentage of CD8+ T lymphocyte predict worse prognosis and aggravation of IPF patients.