传染性非典型肺炎患者外周血CD4+T细胞CD38的表达及意义

The expression of CD38 on CD4+ T cells in peripheral blood of patients with severe acute respiratory syndrome

目的探讨传染性非典型肺炎(急性重症呼吸综合征,SARS)患者外周血CD4+T细胞CD38的表达的变化及其与病程和病情严重程度的关系。方法用双色流式细胞术测定157例SARS临床诊断病例、37例同期发生的肺炎支原体感染患者及38名健康成人外周血淋巴细胞中CD4+T细胞的百分率(CD4%)、CD4+T细胞CD38阳性率(CD38/CD4%)及CD38平均荧光强度(CD38MF)进行检测。结果SARS病例CD4%与健康对照组相比均无统计学意义,但其CD38/CD4%及CD4+T细胞CD38MF显著低于健康对照组(P<0.05,P<0.05);SARS重症患者CD38/CD4%及CD38MF显著低于轻症患,有统计学意义(P<0.01,P<0.001);SARS轻症患者CD4%、CD38/CD4%及CD38MF与健康对照组相比无统计学意义;SARS临床诊断病例CD4%显著高于肺炎支原体感染者,有统计学意义(P<0.01),而CD38/CD4%及CD38MF显著低于肺炎支原体感染,有统计学意义(P<0.01,P<0.01)。结论SARS患者CD4+T细胞CD38的表达降低,降低的水平与SARS病情严重程度相关。CD4+T细胞CD38的表达在SARS诊断病例及肺炎支原体感染中的变化存在统计学意义,CD4+T细胞CD38的表达的检测有助于SARS与肺炎支原体感染的鉴别。

Objective To investigate the expression of CD38 on CD4＋ T cells in the peripheral blood of patients with severe acute respiratory syndrome （SARS） as well as their relationship to the severity of the disease. Methods Peripheral blood samples from 157 cases of severe acute respiratory syndrome （SARS） , 37 cases of mycoplasma pneumonia infection and 38 healthy adult volunteers were measured for the percentage of CD4 ＋ T cell of lymphocytes and the expression of CD 38 on CD4 ＋ cell by dual-color flow cytometry. Results SARS patients did not differ from healthy volunteers in CD4 ＋ cell percentage, but CD38 positive rate of CD4 ＋ cell（ CD38/CD4% ） and mean fluorescent intensity of CD38 （CD38MF） of SARS patients were significantly lower than those of health control respectively （P 〈 0. 05, P 〈0. 05 ）.CD38/CD4% of severe patients was significantly lower than that of mild ones. CD4% in SARS was significantly higher than that in mycoplasma pneumonia infection patients（P 〈0. 01 ）,but CD38/CD4% and CD38MF were much lower than in mycoplasma pneumonia infection（ P 〈 0.01, P 〈0. 01 ）. Conclusion The expression of CD38 on CD4 ＋ T cells was down regulated and correlated with the severity of SARS patients. The alteration of CD38 expression on CD4 ＋ T cells was quite different between SARS andmycoplasma pneumonia infection. The monitoring of CD38 on CD4 ＋ was useful in the differentiation of SARS and mycoplasma pneumonia infection.