老年肺炎患者免疫状态初探

目的 观察老年社区获得性肺炎（CAP）患者免疫功能的改变.方法 以58例老年社区获得性肺炎患者为研究对象,以60例无肺炎体检老年人作为对照组,检测外周血淋巴细胞计数及各淋巴细胞亚群计数,放射免疫法测定外周血肿瘤坏死因子-α（TNF-α）、外周血白细胞介素-2（Interleukin-2,IL-2）等指标,观察老年肺炎患者机体免疫功能变化.结果 肺炎组老年患者与无肺炎组老年人比较,外周血淋巴细胞计数、T淋巴细胞计数（CD＋3）、CD4T淋巴细胞计数（CD＋3CD＋4）、CD＋4/CD＋8比值均明显低（P≤0.001）,NK细胞计数（CD＋16CD＋56）也偏低（P＜0.05）,而CD8T淋巴细胞细胞（CD＋3CD＋8）、B细胞计数（CD＋19）无明显差别（P＞0.05）.肺炎组老年患者与无肺炎组老年人比较外周血TNF-α明显升高（P〈0.001）,外周血IL-2明显偏低（P〈0.001）.结论 老年人免疫功能的减退改变与老年人CAP有着密切的关系.

Investigation on immune state in senile patients with pneumonia

Objective To observe the immune state changes of senile patients with community-acquired pneumonia （CAP） and to explore the role of immune dysfunction in the pathogenesis of senile patients with pneumonia. Methods 58 elderly patients with CAP were selected as the study group, and 60 elderly people without pneumonia were taken as the control group. The count of peripheral blood lymphocyte and lymphocyte subsets, TNF-~ and IL-2 were detected by flow cytometry to observe the changes of immune function. Results The count of peripheral blood lymphocyte and CD3＋ T lymphocyte, CIM T lymphocyte, and the ratio of CD4＋/CD8＋ were significantly lower in the study group than in the control group （P~〈O. 001 ）. The count of NK cells was obviously lower in the study group than in the control group （ P 〈 0. 05 ）, while there was no significant difference on the count of CD8 T lymphocyte cell and B cell between the two groups （ P 〉0. 05 ）. The level of TNF-a was significantly higher, and the level of IL-2 in peripheral blood was significantly lower in the study group than in the control group （ P 〈 0. 001 ）. Conclusion The changes of immune state are closely contributed to susceptibility of elderly patients with CAP.