Objective: To analyze the levels of T lymphocyte subsets (CD3, CD4, CD8 and CD4/CD8) in patients with paraquat poisoning, and to explore the relationship between the changes of T lymphocyte subsets and the prognosis of pulmonary fibrosis. Methods: In October 2019, a total of 47 patients with oral 20% paraquat low water solvent poisoning in Guangzhou 12th people's Hospital from June 2018 to June 2019 were selected as the research objects. Patients were divided into early death group (16 cases died within 2 weeks) and non early death group (31 cases survived more than 2 weeks) . The non early death group was divided into pulmonary fibrosis group (23 cases) and normal lung group (8 cases) . 20 healthy people in the same period were randomly selected as the control group. The neutrophils (N) , C reaction protein (CRP) , alanine aminotransferase (ALT) , creatinine (Cr) , amylase (aAMY) , creatine kinase isoenzyme (CKMB) , pH, HCO(3)(-), blood oxygen saturation (SO(2)) and lactic acid (Lac) of patients poisoned within 3 d were examined every day. Independent sample t-test was used for inter group comparison, and paired sample t-test was used for intra group comparison. Results: Compared with non early death group, the levels of N, CRP, ALT, Cr, aAMY, CKMB and Lac in early death group increased (P<0.05) , while pH and HCO(3)(-) decreased (P<0.05) . Compared with the control group, the levels of CD3, CD4 and CD4/CD8 were decreased on the first day in the early death group and non early death group (P<0.05) , and the levels of CD3, CD4 and CD4/CD8 were decreased on the 15th day in the pulmonary fibrosis group (P<0.05) . Compared with the normal lung group, the levels of CD3, CD4 and CD4/CD8 in the pulmonary fibrosis group decreased on the 15th day (P<0.05) . Conclusion: The persistent low cellular immune function in patients with paraquat poisoning is related to the progress of pulmonary fibrosis, which is an important factor affecting the prognosis of patients with pulmonary fibrosis.
目的： 分析百草枯中毒患者T淋巴细胞亚群（CD3、CD4、CD8和CD4/CD8）水平，探讨T淋巴细胞亚群水平变化与肺纤维化预后的关系。 方法： 于2019年10月，选取2018年6月至2019年6月到广州市第十二人民医院就诊的口服20%百草枯水溶剂中毒患者作为研究对象，共47例。患者根据病程分为早期死亡组（2周内死亡，共16例）与非早期死亡组（存活大于2周，共31例）。非早期死亡组根据肺部情况分为肺纤维化组（23例）和肺正常组（8例）。随机选择同期20名健康者作为对照组。患者在中毒3 d内每天抽血检查中性粒细胞（N）、C反应蛋白（CRP）、谷丙转氨酶（ALT）、肌酐（Cr）、血淀粉酶（aAMY）、肌酸激酶同工酶（CKMB）、酸碱度（pH）、实际碳酸氢根（HCO(3)(-)）、血氧饱和度（SO(2)）和乳酸（Lac）；第1天和第15天检查T淋巴细胞亚群；每周检查一次胸部电子计算机断层扫描（CT）。组间比较用独立样本t检验，组内比较用配对样本t检验。 结果： 与非早期死亡组比较，早期死亡组患者N、CRP、ALT、Cr、aAMY、CKMB、Lac较高（P<0.05），pH和HCO(3)(-)较低（P<0.05）。与对照组比较，早期死亡组、非早期死亡组患者第1天CD3、CD4、CD4/CD8均降低（P<0.05），第15天肺纤维化组患者CD3、CD4、CD4/CD8均降低（P<0.05）。与肺正常组比较，第15天肺纤维化组患者CD3、CD4、CD4/CD8均降低（P<0.05）。 结论： 百草枯中毒患者细胞免疫功能持续低下与肺纤维化的进展有相关性，是影响肺纤维化患者预后的一个重要因素。.
Keywords: Paraquat; Pulmonary fibrosis; T lymphocyte subsets.