摘要
目的:研究人感染H7N9禽流感重症患者免疫调理治疗前后淋巴细胞总数和T淋巴细胞亚群的变化及其对预后的影响,为人感染H7N9禽流感重症患者的抢救治疗提供依据。方法:以我院重症医学科2014年1月来收治的确诊人感染H7N9禽流感重症患者11例为研究对象,入院时检测外周血淋巴细胞总数和CD3+T淋巴细胞(CD3+)、辅助性T淋巴细胞(CD3+CD4+)与抑制性T淋巴细胞(CD3+CD8+)计数,在根据国家卫计委《人感染H7N9禽流感诊疗方案(2014年版)》和《人感染H7N9禽流感诊疗方案(2017年第1版)》指导意见的常规治疗基础上每日加用1.6mg胸腺肽α1皮下注射QD-Q12H进行免疫调理治疗,在免疫调理治疗后测定各患者外周血淋巴细胞总数和T淋巴细胞亚群的变化。结果:免疫调理治疗前人感染H7N9禽流感重症患者外周血淋巴细胞总数和CD3+、CD3+CD4+与CD3+CD8+计数均较正常值降低,其中淋巴细胞总数、CD3+、CD3+CD4计数明显降低(P<0.05);免疫调理治疗后患者外周血淋巴细胞总数和CD3+、CD3+CD4+与CD3+CD8+计数均较治疗前升高,其中淋巴细胞总数、CD3+与CD3+CD8+计数显著升高(P<0.05)。结论:人感染H7N9禽流感重症患者均有淋巴细胞总数减少,T淋巴细胞亚群降低等免疫失衡的表现,胸腺肽α1免疫调理治疗能增加患者淋巴细胞总数和T淋巴细胞亚群,纠正免疫失衡状态,提高抢救成功率。
Objective:To study the change of lymphocyte count and lymphocyte subpopulation after immunoregula-tion in Human Infection with Avian Influenza A(H7N9)Virus to provide some suggestion for the treatment of H7N9 Vi-rus.Methods:11 patients with H7N9 Virus were selected in our ICU from Jan 2014 to present.The lymphocyte countand lymphocyte subpopulation including CD3+T cell,CD3+CD4+T cell,CD3+CD8+T cell in peripheral blood were de-tected when they were admitted to ICU.According to the diagnosis and treatment scheme of the H7N9 Virus(2014 ver-sion)and(2017 version)published by National Health and Family Planning Commission,the patients were given thy-mosinα1,1.6 mg,H,Qd-Q12 h,based on the conventional treatment.After the immunoregulation treatment,lympho-cyte count and lymphocyte subpopulation were tested.Results:Before the immunoregulation treatment,the lymphocytecount and lymphocyte subpopulation decreased compared to the normal range.The lymphocyte count and CD3+T cell,CD3+CD4+T cell decreased obviously(P0.05).Compared to the data before immunoregulation,the lymphocytecount and lymphocyte subpopulation increased after the immunoregulation treatment,up to or almost up to the normalrange.The lymphocyte count and CD3+T cell and CD3+CD8+T cell increased obviously(P0.05).Conclusion:Thepatients with H7N9 Virus show decreased lymphocyte count and lymphocyte subpopulation which is a sign of immune dis-order.The thymosinα1 could increase the lymphocyte count and lymphocyte subpopulation of the patients by immunoreg-ulation,which could increase the survival rate.
出处
《岭南急诊医学杂志》
2017年第5期421-422,438,共3页
Lingnan Journal of Emergency Medicine
关键词
H7N9禽流感
重症
免疫调理
淋巴细胞
T淋巴细胞亚群
治疗
human Infection with Avian Influenza A (H7N9) Virus
critical care
immunoregulation
lymphocytecount
lymphocyte subpopulation
treatment