Comparison Of Sputum Culture Results And Peripheral Blood T Lymphocyte Subsets In Patients With Bronchiectasis

Objective:To detect the levels of CD3 +,CD4 +,CD8 + and CD4 + / CD8 + T lymphocytes in peripheral blood of patients with bronchiectasis and to compare the level under different sputum culture results to study the relationship between sputum culture results and cellular immunity in patients with bronchiectasis.Methods:A total of 79 patients with bronchiectasis diagnosed in Department of Respiratory Medicine,First Hospital of Jilin University from August 2016 to March 2017 were selected,including 33 males and 46 females,aged 34-83 years,with an average age of 63.96 ± 10.33 years.All patients were clinically manifested as long-term repeated cough,cough with plenty of purulent sputum and / or recurrent hemoptysis,and pulmonary CT suggestive of bronchiectasis.All patients met the following exclusion criteria:(1)failed to cooperate with the completion of the relevant examiner;(2)had other than lung infection;(3)the remaining patients with serum albumin or severe weight loss in patients with severe disease;(4)At the same time suffering from malignant tumors,severe cardiovascular and cerebrovascular diseases,previously underwent lung resection patients.At the same time selected 37 cases of physical examination in Jilin University Health Center,18 males and 19 females,aged 45-83 years,with an average age of 60.11 ± 11.10 years.All the above patients should be asked in detail about the history,and complete peripheral blood cell immunity,ESR,C-reactive protein test.Sputum culture tests should also be performed for patients with bronchiectasis.All data are used SPSS21.0 software to complete the data statistical analysis.The values of CD3 +,CD4 +,CD8 +,CD4 + / CD8 + in patients with bronchiectasis and healthy controls were compared,and to compare the values of CD3 +,CD4 +,CD8 +,CD4 + / CD8 + in sputum culture positive group and sputum culture negative group in patients with bronchiectasisand,analyze the relationship between sputum culture results and cellular immunity in patients with bronchiectasis.Result:(1)79 hospitalized patients with bronchiectasis,including 33 males and 46 females,aged 34-83 years,with an average age of 63.96 ± 10.33 years.37 healthy subjects were selected,including 18 males and 19 females,aged 45-83 years,with an average age of 60.11 ± 11.10 years.There was no difference between the two groups in terms of age,gender,smoking history,body mass index,with hypertension or diabetes,and no statistical significance(p>0.05).(2)The counts of CD4 + and CD8 + cells in patients with bronchiectasis were significantly higher than those in healthy controls(p <0.05).Although the counts of CD3 + cells in bronchiectasis group were higher than those in healthy controls,CD4 + / CD8 + is smaller than the healthy control group,but the difference was not statistically significant(p> 0.05).The erythrocyte sedimentation rate and C-reactive protein in patients with bronchiectasis were higher than those in the control group(p<0.05).(3)The numbers of CD3 + and CD8 + cells in sputum culture positive group and sputum culture negative group were significantly higher in patients with bronchiectasis(p<0.05),and the levels of CD4 + / CD8 + were significantly decreased(p <0.05).Although the CD4 + cell count increased,the difference was not statistically significant(p> 0.05).The erythrocyte sedimentation rate and C-reactive protein levels in patients with bronchiectasis positive sputum culture group were higher than those in sputum culture negative group,and the difference was statistically significant(p<0.05).(4)Of the 79 patients with bronchiectasis,there were 22 sputum positive samples(27.85%),of which 8 were Pseudomonas aeruginosa,8 were Candida albicans,and 8 were Klebsiella pneumoniae,5 cases of pneumonia,2 cases of Candida tropicalis,1 case of Stenotrophomonas maltophilia,1 case of Pseudomonas fluorescens,1 case of Acinetobacter jaundice and 1 case of Aeromonas salmonera.The comparison of cellular immunity in patients with Pseudomonas aeruginosa,Candida albicans and Klebsiella pneumoniae pneumonia,which had a higher number of bacteria,showed that there were differences among the three groups in cellular immunity,but the difference was not statistically significant(p> 0.05)Conclusion:(1)Patients with bronchiectasis have more severe peripheral blood T lymphocyte abnormalities and elevated inflammatory markers.The above changes are even more pronounced in sputum culture positive patients.(2)The abnormal cellular immune function and inflammatory response in patients with bronchiectasis may be related to airway pathogen infection.(3)The more severe the inflammatory response in patients with bronchiectasis,the more severe the cellular immune deficiency.