严重急性呼吸综合征患者临床症状和T细胞亚群Meta分析

Analyzing on the clinical symptoms and T cell subsets of patients with severe acute respiratory syndrome

目的:研究严重急性呼吸综合征(SARS)患者临床症状及T细胞亚群变化。方法:检索2003年2月至2004年2月有关SARS患者临床症状及T细胞亚群计数研究的论文,汇合成大样本资料,借助先进的RevMan4.2分析软件对这些资料进行二次分析,以探讨该病患者临床症状和T细胞亚群变化。结果:SARS患者的临床症状按发生的百分率排序依次为:发热99.6%;畏寒62.3%;头痛61.9%;咳嗽59.5%;肌痛/关节痛53.5%;腹泻44.4%;咳痰29.4%;咽喉痛26.9%;流涕23.7%;气促11.7%;胸闷10.0%。SARS病程<14d患者与正常对照比较,CD3+细胞、CD4+细胞、CD8+细胞均显著降低(均P<0.01)。病程>14d恢复期病人与病程<14d病人比较,CD3+细胞虽然有上升,但无显著差异(Z=1.56,P=0.12)。CD4+细胞、CD8+细胞均恢复性上升,差异显著(均P<0.01)。结论:(1)临床症状基本上与卫生部公布的"非典型肺炎临床诊断标准(试行)"符合,但流涕和畏寒症状出现的频率值得探讨。(2)SARS患者CD3+细胞、CD4+细胞、CD8+细胞数量呈暂时性、严重性、可逆性降低;(3)这种降低是可逆性的,随着病程进入恢复期,患者T细胞亚群开始恢复性上升。

Objective：To analyze the clinical symptoms and T cell subsets of patients with severe acute respiratory syndrome. Methods： Indexed thesis for the clinical symptoms and T cell subsets of patients with SARS. Large sample data was synthesized in these theses. The data were analyzed with RevMan 4.2 analysis software. Results： According to percentage of symptom of patients with SARS, common symptoms included fever（ 99.6 % ）, chill（ 62.3 % ）, headache （61.9 % ）, cough （ 59.5 ）, myalgia/art hralgia （ 53.5 % ）, diarrhea （ 44.40% ）, sputum （ 29.4 % ）, angina （ 26.9 ）, snivel（23.7 % ）, and dyspnea（ 11.7 % ）, chest tightly（ 10. 00% ）. SARS patients in course%14 days were compared with healthy subjects, CD3^＋ ,CD4^＋ and CD 8- cell subsets were significantly lower in the SARS patients. CD3^＋ cell subset was not significantly difference,CD4^＋ and CD8^＋ cell subsets were significantly increased in course〉14 days of SARS patients when they were compared with patients in course〈14 days. Conclusion： （1） Although most results of symptoms of patients were in accord with diagnosis criterion of Ministry of Health P. R. China, snivel and chill had more percentage. （2）Both CD3^＋, CD4^＋, CD8^＋ cell subsets of SARS patients in initial stages and progressive stages （coursed〈 14 d）were significantly lower and CD3^＋ ,CD4^＋ CD8^＋ cell subsets of SARS patients in recovery stages were increase. （3）Decline of T cell subsets in SARS patients were reversible.