对IgG阳性SARS患者康复期血清免疫学指标的研究

Prospective clinical study on serum immunity in IgGantibodies positive patients convalescent from severe acuterespiratory syndrome

目的对严重急性呼吸综合征(SARS)康复期患者的血清免疫学指标进行前瞻性的临床研究。方法动态观察SARS患者出院后1、3和6个月时康复期特异性SARSIgG、T细胞亚群和血常规的变化。结果SARS患者血清特异性抗体可作为SARS的确诊依据,在SARS患者出院后6个月时间内,SARS患者血清IgG均呈较高水平,但随着时间的延长,IgG水平呈下降趋势。首次复查时,55.9%的患者T细胞亚群CD4+低于正常,31.2%的患者CD3+低于正常,14.0%的患者CD8+低于正常;第2次复查时绝大部分患者的T细胞亚群恢复至正常。首次复查时,仍有少数患者外周血白细胞异常,至第2次复查时均恢复至正常水平。结论部分SARS患者康复初期的T细胞亚群、白细胞计数均存在异常,至出院后6个月内绝大部分患者各项指标恢复正常;进一步观察SARS抗体水平变化规律,以及对相关异常指标进行跟踪观察研究是必要的。

Objective To investigate the serum immunological characteristics in patients convalescent from severe acute respiratory syndrome(SARS). Methods In the 1 st, 3 rd, 6 th month after their discharge , eg. SARSIgG, T cell subsets, blood routine, and the blood biochemistry were systemically determinedin SARS convalescent patients. Results The SARSantibodies could be used as the diagnostic evidence . During the 6 months after discharge, the titers of SARSantibodies were high, but they lowered alongwith passage of time. At the first recheck, the CD4+ lymphocyte count was lower than normal level in 55.9% of patients, the CD3+ lymphocyte count was lower than normal level in 31.2% of patients, and the CD8+ lymphocyte count was lower than normal level in 14.0% of patients. At the second recheck, the levels of T cell subsets recovered to normal level in the most patients. Conclusion T cell subsets, and the number of leukocyte are abnormalin some patients convalescent from SARS. All the indexes examined recover to normal levels half year after discharge. Therefore, it is necessary to follow up the changes in the levels of SARSantibodies.