Value Of The Detection Of T-lymphocyte Subsets In The Diagnosis And Prognosis Of Senile Pneumonia

Objective: To observe and analyse the relationship between the T-lymphocyte subsets in peripheral blood and the indexes of pulmonary infection,evaluate the value of the detection of T-lymphocyte subsets in the diagnosis and prognosis of senile pneumonia in the early stage.Methods: Totally 210 cases of hospitalized senile patients with pneumonia were selected,who were receiving treatment in our hospital from Sep 2017 to Dec 2018,were enrolled and observed the relationship between the T-lymphocyte subsets-all that CD3+,CD4+,CD8+T-lymphocyte counts,the percentages of CD3+,CD4+,CD8+ and CD4+/CD8+ ratio,and the indexes of pulmonary infection-such as Neu%?CRP and clinical pulmonary infection score(CPIS).The elderly patients with pneumonia were divided into severe pneumonia group(70 cases)and mild pneumonia group(140 cases)because of the severity of pneumonia,also into dead group(34 cases)and survival group(176 cases)according to the different prognosis.The counts of T-Lymphocyte subsets were compared among these groups,and the ROC curve were drawn to observethe value of the T-Lymphocyte subsets in the diagnosis and prognosis of senile pneumonia.Results: CD3+,CD4+,CD8+T-lymphocyte counts,CD3+% and CD4+% were negatively correlated with Neu%,CRP and CPIS in the peripheral blood of senile patients with pneumonia,the ratio of CD4+/CD8+ was also negatively correlated with Neu% and CPIS,the difference is statistically significant(P<0.05),while there was no significant difference between CD8+% and indexes of pulmonary infection,P>0.05.The level of CD3+,CD4+,CD8+ cell counts,CD4+/CD8+ratio,CD3+%,CD4+% and CD8+% in severe pneumonia group were significantly lower than mild pneumonia group,P<0.05.The counts of CD3+,CD4+ and CD8+T-lymphocyte,CD3+%,CD4+% and CD4+/CD8+ratio in dead group were lower than survival group(P<0.05),but there was no statistical difference concerning CD8+% between the two groups,P>0.05.The AUC of CD3+%,CD4+%,CD8+%,CD4+/CD8+ratio,and the counts of CD3+,CD4+,CD8+T-lymphocyte for the diagnosis of severe pneumonia were0.872,0.886,0.599,0.766,0.843,0.859 and 0.771,and the combined index for diagnosing severe pneumonia was 0.934,P<0.05.The AUC of CD3+%,CD4+%,CD4+/CD8+ratio,CD3+,CD4+ and CD8+T-lymphocyte counts for predicting the death were 0.795,0.817,0.735,0.802,0.833 and 0.726,and the integrated index for predicting death was 0.859,P<0.05.There was no significant difference concerning CD8+% for predicting death,P> 0.05.Conclusion: T-lymphocyte subsets in peripheral blood were closely correlated with the index of pulmonary infection,which could improve the accuracy of the diagnosis and prognosis of the pneumonia in the aged.It was important that the detection of T-lymphocyte subsets could provide effective evidence for diagnosis and treatment of senile pneumonia.