以腹泻为首发症状的严重急性呼吸综合征患者的细胞免疫学特点

Diarrhea as the earliest symptom of severe acute respiratory syndrome(SARS) and the damage of cellular immunity

目的 研究以腹泻为首发症状的严重急性呼吸综合征 (severeacuterespiratorysyndrome,SARS)患者细胞免疫学变化的特点 ,为更深入地认识腹泻与SARS的关系提供依据。方法 收集、整理 2 0 0 3年 3月至 7月期间在北京非典型肺炎定点医院确诊SARS患者临床资料 ,建立SARS病历数据库。其中病历完整的为 12 91例 ,记录腹泻为首发症状 (腹泻组 )及首发症状无腹泻 (无腹泻组 )的SARS患者的白细胞总数、淋巴细胞、CD3、CD4、CD8淋巴细胞绝对值 ,研究细胞免疫指标与首发症状有否腹泻之间的关系。结果 2 0 0 3年 3月至 7月期间确诊SARS 12 91例 ,以腹泻为首发症状 10 2例 ,占 7 90 % ,首发症状无腹泻者 132例 ,占10 2 2 %。腹泻组与无腹泻组白细胞总数在正常范围内 ,两组患者淋巴细胞、CD3、CD4、CD8淋巴细胞绝对值均低于正常 ,呈现出发病第 1、2周低 ,第 3、4周逐渐升高的趋势 ;但这些数值在两组之间差异无显著意义 (P>0 0 5 )。结论 腹泻是SARS患者常见的首发症状之一 ,腹泻组与无腹泻组的细胞免疫学变化基本一致 ,两者之间没有差异。

Objective To study the cellular immunity of the SARS patient who the earliest symptom was diarrhea.Methods Clinical data from 1291 patients with SARS during March and July in 2003 were retrospectively analyzed.Data including WBC count,lymphocyte count,CD3,CD4,CD8 T Lymphocyte count.Results 7.9 percent of the patients had diarrhea as the earliest symptom.A significant descent of T lymphocyte subgroup showed the immune systems of SARS patients were impaired,and cellular immune system was seemly as the main target tissue.In the first two weeks,the count of total lymphocytes,CD3,CD4,CD8 lymphocytes had dropped,but with the time went by,they began to rise gradually.But there were no difference between the patients with diarrhea and those without diarrhea.Conclusion Diarrhea is one of the most commonly earliest syndrome of SARS,the relationship between diarrhea and cellular immunity is needing much more research.