摘要
目的探讨隐球菌肺炎患者免疫状态改变特点。方法回顾2017年1月至2020年5月南京鼓楼医院收治的20例非免疫缺陷病毒(HⅣ)感染的隐球菌肺炎患者的临床资料,根据既往免疫状态,将患者分为无免疫抑制组(NICP)和免疫抑制组(ICP),比较组间淋巴细胞亚群及影像学特点。结果20例患者中,男性12例,平均发病年龄(51.00±12.79)岁,NICP组12例。咳嗽是最常见症状。与健康人群相比,隐球菌肺炎患者的CD_(3)^(+)T淋巴细胞、CD_(4)^(+)T淋巴细胞、B淋巴细胞、外周血淋巴细胞计数均降低(P<0.05)。其中,除B淋巴细胞外,NICP组的上述指标均较ICP组高(P<0.05)。NICP组和ICP组间B淋巴细胞计数无显著性差异(P>0.05)。胸部HRCT中病灶多表现为双肺多发结节影或肿块影,可见空洞、毛刺、晕征等多种伴随征象,两组患者的影像学表现无显著差异。结论隐球菌肺炎患者的细胞免疫功能普遍低下,在免疫功能抑制患者中更为显著,隐球菌肺炎患者的体液免疫功能也有不同程度受损。
Objective To explore the characteristics of immune status changes in patients with cryptococcal pneumonia.Methods The clinical data of the 20 non-HⅣpatients diagnosed with cryptococcal pneumonia in Nanjing Drum Tower Hospital from January 2017 and May 2020 were analyzed retrospectively.The patients were grouped according to the past immune condition and were compared by the lymphocyte subgroups and imaging findings.Results Among the 20 cases,there were 12 males,the average onset age was(51.00±12.79)years old.12 cases were non-immunocompromised patients(NICP).The most common clinical symptom was cough.Compared with the healthy population,their CD_(3)^(+)T lymphocyte,CD_(4)^(+)T lymphocyte,B lymphocyte,and total lymphocyte in the peripheral blood were all decreased(P<0.05).The CD_(3)^(+)T lymphocyte,CD_(3)^(+)CD_(4)^(+)T lymphocyte and lymphocyte in the peripheral blood of the NICP group were higher than those of the ICP group(P<0.05).The B lymphocyte level was similar between the two groups(P>0.05).In chest HRCT,the lesions were mostly manifested as multiple nodules or mass shadows in both lungs,with many concomitant signs such as cavities,burrs and halo sign.There was no statistical difference in imaging characteristics between the two groups.Conclusion The cellular immunity was impaired in patients with cryptococcal pneumonia,especially in the patients who were immunocompromised.The humoral immune function of patients with cryptococcal pneumonia was also impaired to varying degrees.
作者
童静植
桂贤华
陈露露
邱玉英
TONG Jing-zhi;GUI Xian-hua;CHEN Lu-lu;QIU Yu-ying(Department of Pulmonary and Critical Care Medicine,Drum Tower Hospital Affiliated to Nanjing University Medical School,Nanjing,Jiangsu 210008,China)
出处
《临床肺科杂志》
2021年第6期836-841,共6页
Journal of Clinical Pulmonary Medicine
关键词
隐球菌肺炎
淋巴细胞
细胞免疫
隐球菌荚膜抗原
cryptococcal pneumonia
lymphocytes
cellular immunity
antigen of cryptococcus capsular
