41例肾综合征出血热患者细胞免疫变化的研究

Alteration of T-lymphocyte Subsets in Peripheral Blood of Hemorrhagic Fever Patients With Renal Syndrome

目的 研究肾综合征出血热 (HFRS)患者外周血T细胞亚群的变化 ,以探讨其在HFRS发病中的作用。方法 应用流式细胞仪检测 4 1例HFRS患者外周血及 10例正常人外周血的T淋巴细胞 (CD3)、亚群CD4、CD8细胞的数量及CD4 /CD8比值。结果 HFRS患者病程中存在CD3、CD4、CD8细胞数量的不同程度升高 ,与对照组相比 ,CD3、CD8细胞数于发热期、低血压期、多尿期均显著高于对照组 (P <0 0 5或P <0 0 1) ;CD4细胞数于低血压期、少尿期明显增高 (P <0 0 1) ;CD4 /CD8比值下降 ,于发热期、低血压期、少尿期明显降低 ,与对照组相比差异有统计学意义 (P <0 0 5或 0 0 1) ;在HFRS不同病型中 ,随病型加重 ,CD3、CD4、CD8细胞数也随之增高 ,在重型达最高值 ,危重型患者略有下降。危重型患者显著升高的CD3细胞以CD8细胞为主 ,病情愈重 ,CD4 /CD8比值愈低。

Objective To study the changes of T-lymphocyte subsets in peripheral blood and to probe the presumable role in the pathogenesis of HFRS. Methods T-lymphocyte subsets CD3、CD4、CD8 cells in peripheral blood of 41 patients with HFRS were detected by flow cytometry. Results In the pathogenesis course of HFRS,CD3、CD4、CD8 cells increased at different level, CD3、CD8 cells increased significantly in fever phase(P<0.05 or P<0.01),peaked in hypotensive phase(P<0.01) and were also higher in diuretic phase compared with normal controls(P<0.05); the increased degree of CD4 cells was lower, CD4 cells didn't increase significantly in fever phase(P>0.05),increased progressively in hypotensive phase(P<0.01),peaked in oliguric phase(P<0.01) and decreased in diuresis stage(P>05); CD4/CD8 ratio decreased or inverted, it decreased significantly in fever stage(P<0.05),was lowest in hypotensive phase,was also obviously lower in oliguric stage(P<0.01) and wasn't significantly increased in diuretic phase(P>05). In different types of HFRS patients, along with the severity of disease, CD3、CD4,CD8 cells increased significantly, but the increased degree of CD4 cells was lower relatively ,CD4 cells peaked in severe type and were higher than that in grave type; CD4/CD8 ratio decreased significantly. Conclusion alteration of T cell subsets might be involved in the pathogenesis of HFRS.