摘要
目的探讨免疫功能与慢性心力衰竭(CHF)并发肺部感染的相关关系,为指导临床治疗提供参考依据。方法选择住院治疗的CHF患者作为研究对象,根据住院期间是否并发肺部感染,分为CHF并发肺部感染组和CHF未并发肺部感染组,比较两组T淋巴细胞亚群(包括CD4+、CD8+和CD4+/CD8+比值)和血清免疫球蛋白(包括IgA、IgG、IgM)的差异,并进行多元回归分析,探讨上述免疫指标对CHF并发肺部感染的影响。结果 CHF并发肺部感染组住院时间和糖尿病病史比例显著高于CHF未并发感染组,差异有统计学意义(P<0.05);CHF并发肺部感染组IgM、IgG、CD8+和CD4+/CD8+均低于CHF未并发肺部感染组,差异均有统计学意义(P<0.05);IgM、IgG、CD4+、CD8+和CD4+/CD8+在3组间比较,差异均有统计学意义(P<0.05);多元回归分析显示,IgG、CD4+/CD8+、住院时间是CHF并发肺部感染的独立危险因素,OR值分别为1.134、1.162和1.126。结论细胞免疫和体液免疫功能低下是CHF并发肺部感染的独立危险因素。
OBJECTIVE To explore the relationship between the immune function and the chronic heart failure （CHF） complicated by pulmonary infections so as to provide basis for the clinical treatment. METHODS The CHF patients were included in the study, and according to the status of pulmonary infections during the hospitalization, the patients were divided into the group of the CHF patients with pulmonary infections （the observation group） and the group of the CHF patients without pulmonary infections （the infection group）. The difference in the peripheral blood T lymphocyte subsets（CD4 ＋ , CD8 ＋ and CD4 ＋/ CD8 ＋）and immunoglobulin（IgA, IgM and IgG） between the two groups were compared by the multivariate regression analysis, and the influence of the immune in- dicators on the incidence of pulmonary infections was observed. RESULTS The proportion taken by the patients with hospital stay and diabetes was significantly higher in the observation group than in the control group, the difference was statistically significant （P〈0.05）. The concentration of IgM, IgG, CD8 ＋ and CD4 ＋ / CD8 ＋ were significantly lower in the observation group than that of the control group. The differences in the IgM, IgG, CD4 ＋ , CD8 ＋ ,and CD4 ＋/CD8 ＋ between the three groups were statistically significant. Multivariate regression a- nalysis found that the IgG, CD4 ＋/CD8 ＋ , and the hospital stay were the independent risk factors for the CHF com- plicated by the pulmonary infection, the OR values were 1. 134, 1. 162, and 1. 126, respectively. CONCLUSION The decreased immune function was the risk factors of pulmonary infection in CHF patients.
出处
《中华医院感染学杂志》
CAS
CSCD
北大核心
2013年第2期305-307,共3页
Chinese Journal of Nosocomiology
关键词
免疫功能
心力衰竭
肺部感染
危险因素
Immune function
Chronic heart failure
Pulmonary infection
Risk factors
