Effects of Drug Therapy on T Lymphocyte Subsets and the Associations of These Subsets with Recurrent Chronic Bronchitis Attacks.

Abstract

Background: We evaluated the effects of drug therapy on T lymphocyte subsets and their associations with recurrent chronic bronchitis (CB) attacks.

Methods: A total of 162 CB patients treated from April 2020 to April 2021 were selected. All patients underwent anti-infective, cough-relieving, and phlegm-eliminating treatment, as detailed in Clinical Pathway for Chronic Bronchitis. They were divided into a recurrent attack group (n=95) and a non-recurrent attack group (n=67). Changes in T lymphocyte subsets at different time points of treatment and their associations with the number of attacks were analyzed. Associated factors were analyzed in a multivariate logistic regression model, and their predictive value was validated using a nomogram prediction model and receiver operating characteristic (ROC) curves.

Results: The number of attacks at 1 year after treatment was positively correlated with CD8⁺ and negatively correlated with CD3⁺, CD4⁺, and CD4⁺/CD8⁺. A history of smoking, CD3⁺, CD4⁺, CD8⁺, and CD4⁺/CD8⁺ were independent risk factors for recurrent attacks. The nomogram prediction model showed that the total risk value corresponding to smoking history, low CD3⁺, CD4⁺, and CD4⁺/CD8⁺, and elevated CD8⁺ was 0.86, and the concordance index and area under the ROC curve of the model was 0.896 (95% CI: 0.782-0.997, P<0.05) and 0.816 (95% CI: 0.803-0.847, P<0.001), respectively. There was an association between T lymphocyte subsets and recurrent attacks before and after treatment of CB.

Conclusions: Low CD3⁺, CD4⁺/CD8⁺ and CD4⁺, elevated CD8⁺, and smoking history were risk factors for recurrent attack.