卒中相关性肺炎血清炎症因子和外周血淋巴细胞亚群的分析

目的 探讨卒中相关性肺炎（SAP）病人血清炎症因子白细胞介素（IL）-1β、IL-6、IL-4、肿瘤坏死因子-α（TNF-α）的水平变化及其临床意义。方法 选取2016年3月至2017年3月收治的48例SAP，根据A2D2S2L评分分为低危（0~2分，14例）、中危（3~9分，15例）、高危（≥10分，19例）三组。入院后次日清晨取空腹静脉血，应用流式细胞仪测定外周血T淋巴细胞亚群（CD3+、CD4+、CD8+），应用酶联免疫吸附试验法检测血清炎症因子（IL-1β、IL-6、TNF-α、IL-4）。结果 随着危险程度的增高，血清IL-1β、IL-6、IL-4、TNF-α水平均明显增高（P<0.05），外周血CD3+和CD4+细胞百分比显著增高（P<0.05）。低危组CD4+/CD8+显著高于高危组和中危组（P<0.05），而后两组无统计学差异（P>0.05）；三组CD3+/CD8+均无显著差异（P>0.05）。结论 血清炎症因子IL-1β、IL-6、TNF-α、IL-4以及T细胞淋巴亚群变化情况反映SAP病人的A2D2S2L评分，血清IL-1β、IL-4、IL-6、TNF-α与A2D2S2L评分呈正相关，T细胞亚群CD3+、CD4+百分比与A2D2S2L评分呈负相关。

Analysis of serum inflammatory factors and peripheral blood lymphocyte subsets in patients with stroke-associated pneumonia

Objective To explore the changes of the levels of serum inflammatory factors and the peripheral blood lymphocyte subsets in patients with stroke-associated pneumonia (SAP). Methods Of 48 patients with SAP treated in our hospital from March, 2016 to March, 2017, 19 with A2D2S2L score≥10 points were in high risk group, 15 with A2D2S2L score 2~9 points in middle risk group and 14 with A2D2S2L score 0~2 points in the low risk group. The serum levels of interleukin (IL)-1β, IL-6, tumor necrosis factor-α (TNF-α) and IL-4 and the status of T cell subsets in peripheral blood were determined in the all the patients. Results The serum levels of IL-1β, IL-6, TNF-α and IL-4 were significantly higher in the high risk group than those in the middle risk group (P<0.05), which were significantly higher than those in the low risk group (P<0.05). The serum levels of CD3+ and CD4+ were significantly higher in the low risk group than those in the middle risk group (P<0.05), which were significantly higher than those in the high risk group (P<0.05).The ratio of CD4+ to CD8+ was significantly higher in the low risk group than that in the middle risk group and the high risk group (P<0.05), but there was insignificant difference in the ratio of CD3+ to CD8+ among the three groups (P>0.05). Conclusion It is suggested that the serum levels of Ⅰ L-1β, IL-6,TNF-α and IL-4 may be positively related to A2D2S2L score, and the serum levels of CD3+ and CD4+ and the ratio of CD4+ to CD8+ were negatively related to A2D2S2L score in the patients with SAP.