目的 观察脑外伤(traumatic brain injury,TBI)合并不同程度获得性肺炎(hospital acquired pneumonia ,HAP)患者外周血T细胞亚群表达水平。方法 连续选择2013-01至2015-06神经外科住院的合并HAP患者31例,另选择同期住院确诊TBI但无HAP患者19例(TBI组),另有同期参加我院体检结论健康者为对照组(23例)。3组对象接受了外周血T细胞亚群(CD3⁺、CD4⁺、CD8⁺、CD4⁺/ CD8⁺)指标检测。结果 TBI合并HAP患者外周血CD3⁺、CD4⁺表达水平[(52.71±5.24)%和(29.30±3.15)%]及CD4⁺/CD8⁺(0.89±0.17)比值明显低于TBI组及对照组( P均<0.05)。同时,TBI合并重度HAP患者外周血CD3⁺、CD4⁺表达水平[(49.64±4.81)%和(28.76±3.04)%]以及CD4⁺/CD8⁺(0.85±0.13)比值明显低于TBI合并轻度HAP患者( P均<0.05)。结论 TBI合并HAP患者存在明确的外周血T细胞亚群表达异常,且随病情加重趋于显著。

Objective To observe the expressions of T cell subsets in the peripheral blood of patients with traumatic brain injury (TBI) combined with hospital acquired pneumonia (HAP).Methods From January 2013 to June 2015, a total of 31 TBI inpatients combined with HAP were successively selected from the Department of Neurosurgery of Liaoning Provincial Corps Hospital. Meanwhile, another 19 inpatients diagnosed with TBI but without HAP were selected as the TBI group, and another 23 healthy physical examinees were assigned to the control group.The three groups of subjects were examined in terms of indexes for the T cell subsets (CD3⁺, CD4⁺, CD8⁺, CD4⁺/CD8⁺) in the peripheral blood.Results The expression levels of CD3⁺ and CD4⁺ in peripheral blood and the CD4⁺/CD8⁺ value in the TBI patients combined with HAP (52.71±5.24% and 29.30±3.15%,0.89±0.17)were obviously lower than those in the TBI group and the control group (Pall<0.05).On the other hand, the expression levels of CD3⁺ and CD4⁺ in peripheral blood and the CD4⁺/CD8⁺ value in the TBI patients combined with severe HAP(49.64±4.81%,28.76±3.04%,0.85±0.13)were obviously lower than those of TBI patients combined with mild HAP ( P all<0.05).Conclusions TBI patients combined with HAP have definitely abnormal expressions of T cell subsets in peripheral blood that become more significant with the aggravation of disease.