长期随访的严重急性呼吸综合征患者T淋巴细胞亚群动态变化

Dynamic Changes of T Lymphocyte Subsets in the Long-term Follow-up of Severe Acute Respiratory Syndrome Patients

目的 研究严重急性呼吸综合征（SARS）患者外周血T淋巴细胞亚群的动态变化,探讨SARS的发病机制.方法 对62例SARS冠状病毒IgG抗体阳性患者进行为期1年的随访,采集患者发病后1周、2周、1月、2～3月及1年时的外周静脉血,采用流式细胞仪检测T细胞、CD4＋T和CD8＋T细胞、纯真及记忆CD4＋T细胞亚群.并以56例健康者作为对照.结果 SARS患者外周血淋巴细胞亚群在康复后短期内有明显恢复.在发病2～3月时,CD8＋T细胞数与正常对照相比差异无显著性,平均CD4＋T细胞及纯真CD4＋T细胞数已分别增加至（534±197）/mm^3和（175±75）/mm^3.但发病1年时淋巴细胞总数、T细胞、CD4＋T细胞和纯真CD4＋T细胞数仍低于正常对照组.结论 SARS患者外周血T淋巴细胞亚群表现为可逆的一过性快速减少及恢复.

Objective To study the dynamic changes of T lymphocyte subsets in severe acute respiratory syndrome （SARS） patients. Methods Sequential anti-coagulated blood samples were collected from 62 seropositive SARS patients during the first week, the second week, the first month, the 2nd-3rd month, and 1 year after disease onset. T-lymphocyte subsets including CD4 ＋ T cells, CD8 ＋ T cells, and naive and memory CD4 ＋ T cells were detected by flow cytometry. Samples from 56 healthy blood donors were also detected as healthy controls. Results A rapid restoration in T-lymphocyte subsets was observed during a short period after infection. During the 2-3 months after disease onset, CD8 ＋ T cell count returned to the normal level. At the same time point, CD4 ＋ T cell and naive CD4 ＋ T cell counts increased to （534 ± 197） /mm^3 and （175 ±75 ） /mm^3 respectively. Total lymphocytes, T lymphocyte, CD4 ＋ T and naive CD4 ＋ T cell were still significantly lower than the normal levels even one year after disease onset. Conclusion The periphery T lymphocyte subsets in SARS infection shows transient decrease and then rapid recovery.