老年重症肺炎患者细胞免疫功能的初步研究——附60例报告

目的：探讨老年重症肺炎患者的细胞免疫功能变化。方法：筛选老年重症肺炎患者60例（老年重症组）、老年非重症肺炎患者34例（老年非重症组）、非老年重症肺炎患者9例（非老年重症组）、非老年非重症肺炎患者21例（非老年非重症组），流式细胞术检测其外周血T细胞亚群（CD3^＋、CD4^＋、CD8^＋、CD4^＋／CD8^＋）及NK细胞的活性。结果：老年重症组患者CD3^＋、CD4^＋、CD8^＋及NK细胞活性比老年非重症组明显下降（P均〈0．01）。非老年重症组患者CD3^＋、CD4^＋及NK细胞活性均低于非老年非重症组（P〈0．05或0．01）。老年重症组患者CD3^＋、CD8^＋均低于非老年重症纽（P均〈0．05）。老年非重症组与非老年非重症组的各项指标比较差异均无统计学意义（P均〉0．05）。结论：重症肺炎患者细胞免疫功能较非重症肺炎患者下降，其中老年重症肺炎患者细胞免疫功能下降更明显。免疫功能减退可能是老年患者发生重症肺炎的原因之一。

Cellular immune function of the elder patients with severe pneumonia:a report of 60 cases

Objective： To investigate the immune function of the elder patients with severe pneumonia. Methods： Sixty elder patients with severe pneumonia （ group A） , thirty-four elder patients with common pneumonia （group B）, nine adults with severe pneumonia （group C）, and twenty-one adults with common pneumonia （ group D） were enrolled. Indexes of T lymphocyte subset such as CD3 ^＋ , CD4 ^＋ , CD8 ^＋ , CD4 ^＋/CD8 ^＋ and activity of natural killer cell （NK cell） were detected in all patient samples by flow cytometry. Results： The percentage of CD3 ^＋ , CD4 ^＋ , CD8 ^＋ , and activity of NK cell in group A were lower than those in group B （P 〈0.01 each）. Furthermore, the percentage of CD3 ^＋ , CD4 ^＋ , and activity of NK cell in group C were lower than those in group D （P 〈0. 05 or 0. 01 ）. Meanwhile, the percentage of CD3 ^＋ , CD8 ^＋ in group A were lower than that in group C （P 〈0. 05 In each）. However, there was no significant differences in every indexes between group C and group D （ P 〉 0. 05 ）. Conclusion ： The immune function of the patients with severe pneumonia is decreased, especially in elder patients. Lower immune function may be one of the reason causing severe pneumonia in elder patients.