输入性登革热不同型别与T淋巴细胞亚群的相关性

Correlation between Different Types of Imported Dengue Fever and T-lymphocyte Subsets

目的通过观察输入性登革热患者T淋巴细胞亚群的变化,探讨与登革病毒型别的相关性。方法将64例登革病毒核酸检测阳性者进行病原分型,采用流式细胞术分别检测发病早期及恢复期外周血中CD3+、CD4+、CD8+绝对值,并对同型别病例早期与恢复期进行比较,不同型别病例进行两两比较。同时比较临床表现、炎症指标、重要脏器功能。结果 64例均来自南亚、东南亚(占78.13%);其中登革病毒Ι型37例,Ⅱ型5例,Ⅲ型9例,Ⅳ型13例;4型登革热的临床表现、WBC、PLT、Hs CRP、PCT、肝功、心肌酶多无明显差异(P>0.05); 4型CD3+,CD4+,CD8+绝对数早期与恢复期相比差异均存在统计学差异(P<0.05),4型CD4+、CD8+绝对数早期分别相比均无统计学差异(P>0.05);CD3+与CD4+、CD8+的变化呈正相关(r=0.945,r=0.913,均P <0.001);CD4+在Ι、Ⅱ、Ⅳ型组约60%以上的病例降低;CD8+在Ι、Ⅱ、Ⅲ型组月40%以下的病例升高;CD4+与CD8+同时降低见于Ι、Ⅱ、Ⅳ型组;CD8+同时升高及降低见于Ι、Ⅱ、Ⅲ型组。结论本组登革热均为南亚、东南亚输入病例,以Ι型多见,其余3个型别也存在。四型病例在临床表现,Hs CRP、PCT、肝功及心肌酶,以及CD3+、CD4+、CD8+T淋巴绝对值等均无明显差异。早期多出现CD4+、CD8+异常下降或/和升高,均存在细胞免疫功能紊乱,恢复期基本恢复正常,说明机体细胞免疫功能的可调节性以及干预治疗的有效性。监测T淋巴细胞亚群可以评估登革热治疗效果以及预后。

Objective To investigate the correlation of dengue virus type and T lymphocyte subsetsby observing the changes of T lymphocyte subsets in the patients with the type I. Methods 64 cases of dengue virus nucleic acid test were carried out by pathogen type,and flow cytometry was used to detect the absolute value of cd3+,cd4+ and cd8+ in the peripheral blood during the early stage and recovery period,and compared the early and recovery period of the same type cases,compared with 22 in different type cases. At the same time,the clinical manifestations,inflammation index,important organ function were compared. Results 4 cases were from South Asia,Southeast Asia (78.13%),including dengue virus Ⅰ Type 37 cases,Ⅱ type 5 cases,Ⅲ type 9 cases,Ⅳ type 13 cases,four types of dengue fever clinical manifestations,WBC,PLT,HsCRP,PCT,liver work,myocardial enzymes are not significantly different(P>0.05).There was a statistically significant difference between the absolute numbers of the four cd3+,cd4+,cd8+ and the recovery period(P<0.05).There was no statistically significant difference between the four-type cd4+ and cd8+ in the early absolute numbers (P>0.05).Conclusions The dengue fever in this group was imported from South Asia and South-East Asia,and the other three types were found in Ⅰ type. There were no significant differences in clinical manifestations,HsCRP,PCT,hepatic function and myocardial enzymes,and absolute value of CD3+,CD4+and CD8+ lymph in four cases. Early occurrence of CD4,CD8+abnormal decline or/and elevated,there are cellular immune dysfunction,recovery period basically return to normal,indicating the regulation of somatic immune function and the effectiveness of intervention therapy. Monitoring T lymphocyte subsets can assess the efficacy and prognosis of dengue fever.