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目的探讨急性上呼吸道感染患者血常规中中性粒细胞和淋巴细胞变化的年龄差异和性别差异及其临床意义。方法 291例呼吸道感染患者和219例正常志愿者,分为六个年龄组,采用VCS法检测患者外周血中性粒细胞、淋巴细胞的变化状态;采用流式细胞标记法检测外周血CD4+、CD8+T细胞亚群的比例变化和TNFα分泌能力,并分析性别和年龄差异。结果急性呼吸道感染患者外周血中中性粒细胞计数和比例均明显升高,中性粒细胞比例升高1～2倍是白细胞升高的主要原因,淋巴细胞比例明显下降。该类患者血常规中中性粒细胞随着增龄而升高,增幅也随之升高;而淋巴细胞随着增龄而明显降低。女性在更年期血常规中中性粒细胞和淋巴细胞的变化明显低于男性和其他组患者(P<0.05)。另外,随着淋巴细胞比例降低,CD4/CD8随着年龄的增长而显著升高,分泌TNFα能力在30~40岁组明显高于其他年龄组。结论衰老和激素水平可以影响上呼吸道感染患者血常规中中性粒细胞和淋巴细胞的水平,这一结果可为临床病情判断及针对不同人群采用不同防治方案提供重要依据。
Objective To investigate the age-variability and gender differences of blood neutrophils and lymphocytes in patients with acute upper respiratory tract infection and their clinical significance. Methods Totally 291 patients with respiratory tract infection and 219 normal volunteers were divided into six age groups. The changes of peripheral blood neutrophil and lymphocyte were detected by VCS method. The levels of CD4 +, CD8 + T cell subsets and secretion of TNFα, and analyzed the gender and age differences. Results The number and proportion of neutrophils in peripheral blood of patients with acute respiratory infection were significantly increased. The proportion of neutrophils was increased by 1 ~ 2 times, which was the main reason of leukocytosis. The proportion of lymphocytes decreased obviously. Such patients with blood routine neutrophils increased with age, the increase also increased; while lymphocytes decreased with age. The changes of neutrophils and lymphocytes in menopausal women were significantly lower than those in men and other groups (P <0.05). In addition, as the proportion of lymphocytes decreased, CD4 / CD8 increased significantly with age, and the ability to secrete TNFα was significantly higher in the 30-40 age group than in other age groups. Conclusion Aging and hormone levels can affect the level of neutrophil and lymphocyte in the blood of patients with upper respiratory tract infection. This result may provide an important basis for judging the clinical condition and using different control strategies for different populations.