中老年脊柱手术后患者血清维生素D和T细胞亚群水平变化与术后感染的关系

目的 探讨维生素D(VitD)和T细胞亚群水平变化与中老年脊柱手术后患者感染的关系。方法 以2013年1月至2017年12月某院脊柱手术后并发感染的中老年患者41例为观察组并分为感染评分高组和低组,选择同期治疗42例手术后未感染者为对照组;抽取静脉血检测患者血清VitD和T细胞亚群(CD3+数目以及CD4+/CD8+)水平情况。结果 感染评分高、低组VitD水平、CD3+数目及CD4+/CD8+比值均低于对照组(P＜0.05);感染评分高组VitD水平、CD3+数目及CD4+/CD8+比值低于低组(P＜0.05);Spearman相关分析显示老年脊柱手术后患者VitD水平、CD3+数目、CD4+/CD8+比值与感染评分呈负相关(P＜0.001);多重线性回归分析显示，VitD水平与CD3+数目及CD4+/CD8+比值呈正相关(t=6.842和6.9333,P<0.001)。结论 VitD和Ｔ淋巴细胞亚群水平降低的中老年脊柱手术后患者感染风险增加;VitD水平与中老年脊柱手术后患者免疫功能相关。

Relationship between changes of serum vitamin D,T cell subsets and postoperative infection in middle-elderly patients after spinal surgery

Objective To investigate the relationship between the changes of serum vitamin D,T cell subsets level and postoperative infection in middle-aged patients after spinal surgery.Methods From January 2013 to December 2017,41 cases of middle-aged patients with a postoperative infection after spinal surgery in our hospital were selected as observation group with high and low infectious score group.At the same time,42 postoperative patients who were not infected were selected as a control group.The venous blood was taken to detect the levels of serum VitD and T cell subsets(CD3+,CD4+/CD8+).Results The levels of VitD,CD3+ and CD4+/CD8+ in the high and low infectious score group were lower than that of the control group(P<0.05)The levels of VitD,CD3+ and CD4+/CD8+ in the high infectious score group were lower than low infectious score group(P<0.05).Spearman correlation analysis showed that the levels of VitD,CD3+ and CD4+/CD8+ were negatively correlated with the infection scores(P<0.001),and Linear regression analysis showed that the level of VitD was positively correlated with CD3+ and CD4+/CD8+(t=6.842 and 6.9333,P<0.001).Conclusion Reduced VitD and T lymphocyte subsets will increase the risk of infection in middle-aged patients after spinal surgery.The vitd level is associated with an immune function in middle-aged and elderly patients after spinal surgery.