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淋巴细胞亚群变化

The Change of Lymphocyte Count and Lymphocyte Subpopulation after Immunoregulation Treatment in Human Infection with Avian Influenza A(H7N9)Virus

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.