T-lymphocyte Count Predicts The Severity Of Elderly Patients With Community-acquired Pneumonia And The Use Of The Judgement Of Antibiotic Sensitivity

Objective:To explore the correlation between T-lymphocyte count and the severity of pneumonia as well asdrug resistance of pathogens in the elderl y patients with community-acquired pneumonia(CAP).This study will provide a scientific basis for the early diagnosis of bacterial community-acquired pneumonia in the elderly and the selection of antibiotics.Methods:The clinical data of 159 patients(81 males,78 females)with community-acquired pneumonia over 65 years old admitted from May 1,2018to May 31,2019 were analyzed retrospectively.Patients were div ided into severe pneumonia group(SP group)and non-severe pneumonia group(NSP group)and the T-lymphocyte count between the two groups was compared..The ability of CD4~+T lymphocyte count to predict severe pneumonia was studied by ROC curve.The correlation between CD4~+T cell count and PSI was studied by Spearman correlation analysis.The differences of WBC,NEUT%,hs CRP,PCT and PSI between CD4~+T cell count<200/mm~3 group(<200 group for short,n=22)and≥200/mm~3 group(≥200 group for short,n=137)were compared by Kolmogorov-Smirnov test and the drug resistance of strains was compared between the two groups.Results:The CD3~+T-lymphocyte count and CD4~+T-lymphocyte count of the SP group were lower than th ose of the NSP group(P<0.05),but there was no significant difference in CD8~+T-lymphocyte count(P>0.05).The ROC curve showed that CD4~+T-lymphocyte count could predict severe pneumonia(AUC=0.827,P<0.05).There was a strong negative correlation between CD4~+T-lymphocyte count and PSI score.PCT,CRP,WBC,NEUT%and PSI scores of<200 group were higher than those of≥200 group(P<0.05).The antibiotic sensitivity of the same strain was lower in the<200 group.Conclusion:The T-lymphocyte count can be used to judge the severity of CAP in the elderly and select antibiotics.When the CD4~+T-lymphocyte count is less than 200/mm~3,the inflammatory response of the patients with pneumonia is stronger,while the sensitive antibiotics are less.