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

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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.

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