恙虫病患者外周血T淋巴细胞亚群的变化及相关护理

Changes of T-lymphocyte subsets in peripheral blood of patients with tsutsugamushi disease and pertinence nursing

目的探讨T淋巴细胞亚型在恙虫病的致病过程中的变化及意义,总结针对恙虫病患者的护理经验。方法用流式细胞术检测16例恙虫病患者(A组)治疗前后和20例健康人(B组)静脉血中CD4+、CD8+和调节性T细胞(Treg)的比例。结果 A组治疗前外周血中CD4+和CD8+T细胞为(38.5±4.0)%和(25.5±4.3)%,均明显低于B组的(45.2±8.5)%和(31.6±6.8)%(P<0.05),而Treg细胞占CD4+T细胞的百分比显著高于B组[(12.7±3.2)%vs.(5.4±1.9)%](P<0.05)。与治疗前比较,A组治疗后CD4+和CD8+T细胞比例升高为(42.7±7.4)%和(29.6±6.1)%,Treg细胞占CD4+T细胞百分比降低至(9.2±2.1)%(P<0.05)。除常规护理,对1例并发肺炎和2例轻度肝损伤患者做了针对性护理。结论 T淋巴细胞在恙虫病的致病过程中发挥了重要作用。早期确诊和及时抗病原治疗以及针对性护理是治疗恙虫病的关键。

Objective To investigate the variations of T-lymphocyte subsets in peripheral blood of patients with tsutsugamushi disease and summarize the experiences of pertinence nursing. Methods With flow cytometry, the percentages of CD4＋ , CD8＋ T-cells and Treg cells in peripheral blood were measured in 16 patients with tsutsugamushi disease（group A） and 20 healthy controls （group B）. Results The percentages of CD4＋ and CD8＋ T cells in group A were （38. 5±4. 0）% and （25.5± 4. 3）% before therapy, which were lower than （45.2 ± 8.5）% and （31.6 ± 6.8）% in group B （P〈0.05） and increased to （42.7 ± 7.4）% and （29.6 ± 6.1）% after treatment （P〈0. 05）. The percentage of Treg in CD4＋ T-cells was （12. 7±3.2）% before treatment,which was higher than （5.4 ± 1.9）% in group B（P〈0. 05） and decreased to （9.2 ± 2.1）% after therapy（P〈0. 05）. Except for conventional nursing, the patients with complications of pneumonia （1 case） and hepatic injury （2 cases） were given pertinent nursing. Conclusion T lymphocytes play an important role in the course of tsutsugamushi disease. The keys for treating are early diagnosis, effective therapy and pertinent nursing.