发热伴血小板减少综合征患者外周血T淋巴细胞检测及免疫功能研究

Study on peripheral blood T lymphocyte detection and immune function among patients of fever with severe thrombocytopenia syndrome

目的通过检测发热伴血小板减少综合征(SFTS)患者外周血中T淋巴细胞亚群的变化特点以及外周血清中部分细胞因子的表达水平,探讨SFTS布尼亚病毒感染后机体的免疫功能改变。方法收集2017年4～11月济南市所属辖区内医院36例SFTS患者和10例健康对照者外周血。采用流式细胞仪检测其外周血中CD3+、CD4+及CD8+T淋巴细胞数量;采用液态芯片仪检测外周血清中部分细胞因子表达水平。结果 SFTS患者急性期外周血CD4+T淋巴细胞绝对数(323±94.38)低于对照组(987±42.73)(P <0.01);CD8+T淋巴细胞绝对数(476±45.34)低于对照组(683±68.55)(P <0.05)。SFTS患者急性期IFN-r、IL-6、TNF-α因子表达水平(38.18±26.86、148.5±129.77、110.97±46.67)明显高于对照组(20.11±5.62、28.67±9.00、55.5±13.54)(P <0.05、0.01);IL-1b、IL-2、IL-8、IL-10表达水平(30.44±30.78、8.82±5.58、1269.42±2333.75、53.68±43.22)明显低于对照组(52.83±25.89、18.83±5.57、2 975.83±2 742.38、92.89±20.30)(P <0.05、0.05、0.01、0.05);IL-4表达水平(16.67±8.67)与对照组(19.72±5.77)差异无统计学意义(P>0.05)。SFTS患者恢复期IL-1b、IL-2、IL-6、IL-8、IL-10细胞因子表达水平(236.86±231.26、17.88±15.92、903.02±380.31、9 032.5±7 929.88、112.35±102.45)较急性期(30.44±30.78、8.82±5.58、148.5±129.77、1269.42±2333.75、53.68±43.22)有不同程度升高(P <0.01、0.05);IL-4、IFN-r、TNF-α细胞因子表达急性期与恢复期差异无统计学意义(P>0.05)。结论 SFTSV感染后患者体内CD3+、CD4+T淋巴细胞降低明显,CD4+/CD8+比值降低。SFTS患者外周血清中细胞因子表达水平在SFTSV感染后发生明显改变。

Objective To explore the changes of immune function of the body after severe fever thrombocytopenia syndrome bunyavirus（SFTSV）infection by detecting T lymphocyte subsets in peripheral blood of severe fever thrombocytopenia syndrome（SFTS）patients and the expression levels of some cytokines in peripheral blood. Methods Peripheral blood samples were collected from 36 SFTS patients and 10 healthy controls in hospitals in Jinan from April to November,2017.The numbers of CD3＋,CD4＋and CD8＋T lymphocytes in peripheral blood were measured by flow cytometer.The expression levels of some cytokines in peripheral blood were detected by liquid chip. Results The absolute number of CD4＋T lymphocytes（987±42.73）in the peripheral blood of acute SFTS patients was statistically significant lower than that of the control group（323±94.38）（P 〈0.01）.The absolute number of CD8＋T lymphocytes（476±45.34）in the peripheral blood of SFTS patients was statistically significant lower than that of the control group（683±68.55）（P 〈0.05）.The expression levels of IFN-r,IL-6 and TNF-αfactors in the acute stage of SFTS patients（38.18±26.86,148.50±129.77,110.97±46.67）were significantly higher than those in the control group（20.11±5.62,28.67±9.00,55.5±13.54）（P 〈0.05,0.01）.IL-1 b,IL-2,IL-8,and IL-10 expression levels（30.44±30.78,8.82±5.58,1 269.42±2 333.75,53.68±43.22）were significantly lower than those of the control group（52.83±25.89,18.83±-5.57,2 975.83±2 742.38,92.89±20.30）（P 〈0.05,0.01）.There was no significant difference in IL-4 expression level between patients（16.67±8.67）and control group（19.72±5.77）（P 〈0.05）.The expression levels of IL-1 b,IL-2,IL-6,IL-8,and IL-10 cytokines in the convalescent stage of SFTS patients（236.86±231.26,17.88±15.92,903.02±380.31,9032.5±7 929.88,112.35±102.45）were higher than those in the acute stage（30.44±30.78,8.82±5.58,148.5±129.77,1269.42±2 333.75,53.68±43.22）with different degrees of increase（P 〈0.01,0.05）.There was no significant difference in the expression of IL-4,IFN-R and TNF-alpha cytokines between the acute phase and the recovery stage（P〉 0.05）.Conclusion There is a significant decrease in both the CD3＋and CD4＋T lymphocytesand CD4＋/CD8＋T lymphocytes of patients after SFTSV infection.The expression levels of cytokines in peripheral blood of SFTS patients were significantly changed after SFTSV infection.