恢复期SARS患者淋巴细胞亚群分布及其与T淋巴细胞Ag-NOR含量相关性的初步分析

A primary analysis about the distribution of lymphocyte subpopulations and its relationship to Ag NORs′ content of patients with convalescent SARS

目的 通过检测恢复期SARS患者外周血淋巴细胞亚群分布及其与T淋巴细胞核仁形成区嗜银蛋白 (Ag NOR)含量的相关性分析 ,探讨恢复期SARS患者的免疫状态及淋巴细胞亚群与活性状态改变的关系。方法 以流式细胞术检测患者外周血淋巴细胞亚群 ,用KL型免疫图像分析系统检测外周血T淋巴细胞Ag NOR ,对两者进行相关分析。结果 恢复期患者T淋巴细胞总数及CD4 +亚群基本正常 ,而CD8+亚群偏高 ,CD4 +/CD8+降低 ,CD4 +/CD8+<1的比例占 37.4 % ,激活T细胞中以CD8+细胞为主。B细胞比例正常。NK细胞明显低于对照组。重症患者CD4 +、CD4 +/CD8+、CD1 9+CD5+降低及CD8+、CD3+HLA DR+升高。 50岁以上及使用大剂量激素患者CD3+HLA DR+升高。淋巴细胞Ag NOR的含量 (IS % )在正常范围 ,但患者IS值呈偏态分布 ,低于正常范围者占 4 4.99%。淋巴细胞Ag NOR的含量与CD3+、NK、CD3+HLA DR+、CD3+CD2 5+在统计学上具有相关性。结论 恢复期SARS患者免疫功能趋于恢复正常 ,但部分患者的淋巴细胞亚群数量及淋巴细胞活性仍未恢复正常 ,这些病人在临床症状得到改善之后 ,尚需一定时间的观察随访 ,以了解SARS病毒对人体免疫机能的长期影响。

Objective To investigate the immune state of the lymphocyte subgroups and its active state in the patients with convalescent SARS by testing their distribution of the blood lymphocyte subgroups and to analyze relationship with the Ag NORs′ content. Methods The peripheral lymphocyte subgroups of the patients were tested by flowcymetry and the Ag NORs′ content of the T cells were tested by KL immune picture analysis system. The relationship of the two items was analyzed. Results The number of the total T lymphocytes and CD4 + subgroup was almost normal, but that of CD8 + increased. The ratio of CD4 +/CD8 + lowered, which less than 1 was 37.4%. The activated T lymphocytes were mostly CD8 + cells. The number of B lymphocytes was normal, but that of NK cells was lower in patients than that of control apparently. The number of CD4 +, CD4 +/CD8 +, CD19 +CD5 + decreased and that of CD8 +, CD3 +HLA DR + increased in the severe cases. The number of CD3 + HLA DR + rose in those older than 50 years old or treated by high dose hormone. The content of Ag NORs(IS%) was in normal range, but the IS value of the patients showed an abnormal distribution. The IS value in 44.99% patients was lower. The content of Ag NORs statistically correlated to CD3 +, NK, CD3 +HLA DR +, CD3 +CD25 +. Conclusion The immune function of the patients with convalescent SARS trended normal, but some of them had an abnormal counting of lymphocyte subgroups and lymphocyte activity. So, these patients should be followed up for a longer period to find out the secular effect of SARS virus on the immune function after their clinical symptoms had been improved.