T淋巴细胞亚群及营养状态与老年重型颅脑损伤患者预后间的关系研究
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重庆医科大学附属大足医院重症医学科

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重庆市大足区科技发展项目(DZKI2023-JSYJ-KWXM1036) 重庆市科技局科研基金资助项目(2022L029)


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Intensive Care Medicine Department The Affiliated Dazu Hospital of Chongqing Medical University

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    摘要:

    摘要 目的:研究T淋巴细胞亚群及营养状态与老年重型颅脑损伤患者预后间的关系。方法:回顾性分析我院收治的109例老年重型颅脑损伤患者临床资料,包括基础资料、T淋巴细胞亚群及营养状态[营养风险筛查量表2002(NRS2002)评分和血清白蛋白(ALB)水平]。根据患者出院3个月后的格拉斯哥预后评分(GOS)情况将患者分为预后良好组(n=56)与预后不良组(n=53),对比两组临床资料,并采用多因素Logistic回归分析影响老年重型颅脑损伤患者预后的影响因素。结果:预后不良组T淋巴细胞亚群CD4+、CD4+/CD8+水平均低于预后良好组(P<0.05),CD8+水平高于预后良好组(P<0.05)。预后不良组NRS2002评分高于预后良好组(P<0.05),ALB水平低于预后良好组(P<0.05)。预后不良组入院格拉斯哥昏迷评分(GCS)评分、颅内血肿量、入院血糖、入院收缩压(SBP)、入院舒张压(DBP)与预后良好组比较差异有统计学意义(P<0.05)。多因素Logistic回归分析结果显示,CD4+/CD8+、NRS2002评分、ALB水平、入院GCS评分、颅内血肿量、入院血糖、入院SBP是影响老年重型颅脑损伤患者预后的因素(P<0.05)。结论:T淋巴细胞亚群及营养状态与老年重型颅脑损伤患者预后存在关联,增强患者免疫功能,增强其营养状态或可改善患者预后。

    Abstract:

    Abstract Objective: To study the relationship between T lymphocyte subsets and nutritional status and prognosis in elderly patients with severe craniocerebral injury. Methods: The clinical data of 109 elderly patients with severe craniocerebral injury admitted to our hospital were retrospectively analyzed, including basic data, T lymphocyte subsets and nutritional status [Nutritional Risk Screening Scale 2002 (NRS2002) score and serum albumin (ALB) levels]. According to Glasgow prognosis score (GOS) 3 months after discharge, patients were divided into good prognosis group (n=56) and poor prognosis group (n=53). The clinical data of the two groups were compared, and the factors affecting the prognosis of elderly patients with severe craniocerebral injury were analyzed by multivariate Logistic regression. Results: The levels of CD4+ and CD4+/CD8+ of T lymphocyte subsets in the poor prognosis group were lower than those in the good prognosis group (P<0.05), and the levels of CD8+ were higher than those in the good prognosis group (P<0.05). The NRS2002 score of the poor prognosis group was higher than that of the good prognosis group (P<0.05),ALB level was lower than that of good prognosis group (P<0.05). There were significant differences in Glasgow coma score (GCS), intracranial hematoma volume, blood glucose, systolic blood pressure (SBP) and diastolic blood pressure (DBP) between poor prognosis group and good prognosis group (P<0.05). Multivariate Logistic regression analysis showed that CD4+/CD8+, NRS2002 score, ALB level, admission GCS score, intracranial hematoma volume, admission blood glucose and admission SBP were the factors that affected the prognosis of elderly patients with severe cranial brain injury (P<0.05). Conclusion: T lymphocyte subpopulation and nutritional status are associated with the prognosis of elderly patients with severe craniocerebral injury. Enhancing the immune function and nutritional status of patients may improve the prognosis of patients.

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  • 收稿日期:2024-02-29
  • 最后修改日期:2024-06-03
  • 录用日期:2024-06-11
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