宁夏定点医院新型冠状病毒肺炎患者机体免疫状态临床研究

Clinical study on the immune status of COVID-19 patients in Ningxia designated hospital

目的研究新型冠状病毒肺炎患者机体体液免疫和细胞免疫状态。方法收集71例新型冠状病毒肺炎患者资料进行回顾性分析。分为轻型组13例,普通型组44例,重及危重型组14例,观察3组患者体液免疫和细胞免疫指标3组,并对治疗前后相关指标的变化进行分析。结果入院时3组患者体液免疫指标均正常,3组患者补体3(C3)、补体4(C4)水平均在正常范围,3组比较差异有统计学意义(P<0.05)。3组患者T淋巴细胞百分比及轻型T淋巴细胞绝对值均正常。普通型和重及危重型患者T淋巴细胞绝对数目均降低,3组比较差异有统计学意义(P<0.05)。出院时3组患者体液免疫指标均正常。3组患者C3、C4水平均在正常范围,3组C4比较差异有统计学意义(P<0.05)。3组患者T细胞免疫指标CD45#、CD3^+#、CD3^+CD8^+#、CD3^+CD4^+CD8^+#均增高,3组比较差异有统计学意义(P<0.05);治疗前后轻型患者IgG、IgM比较差异有统计学意义(P<0.05),普通型、重及危重型患者IgG、IgM、C4比较差异有统计学意义(P<0.05)。结论新型冠状病毒肺炎患者机体存在免疫功能紊乱状态,入院时部分免疫指标降低,经治疗出院时增高,临床疗效满意。新型冠状病毒肺炎患者在进行抗病毒治疗的同时,及时对患者实施免疫调节治疗,可缩短疗程,提高治愈率。

Objective To study the humoral and cellular immunity status of COVID-19 patients.Methods 71 cases of COVID-19 patients were collected and analyzed retrospectively.The patients were divided into the neutral group(13 patients),the normal group(44 patients),and the severe and critical group(14 patients).The humoral and cellular immune indexes and other indicators of the three groups were observed and the changes of the relevant indicators were analyzed.Results At the time of admission,the humoral immune indexes of the three groups were normal.The levels of complement 3(C3)and complement 4(C4)in the three groups were located in the normal range,and the differences among the three groups were sttistically significant(P<0.05).The percentage of T lymphocytes and the absolute value of soft T lymphocytes were normal in the three groups.The absolute number of T lymphocytes was lowered in the normal,the severe and critical patients,and the difference among the three groups were statistically significant(P<0.05).The humoral immune indexes of the three groups were normal at the time of discharge.The levels of C3 and C4 in the three groups were in the normal range,and the difference of C4 in the three groups were statistically significant(P<0.05).Three groups of patients with T cell immune indexes CD45#,CD3^+#and CD3^+CD8^+#and CD3^+CD4^+CD8^+#were all increased,and the difference was statistically significant among the three group(P<0.05).Compared with the changes of indexes before and after treatment,the difference of IgG and IgM in the neutral group was statistically significant(P<0.05).IgG,IgM and C4 were statistically significant between the normal and the critical patients(P<0.05).Conclusion NCP patients have immune dysfunction.Some immune indexes decrease at admission,and increase on discharge after treatment,indicating satisfactory clinical efficacy.When NCP patients receive antiviral therapy,timely implementation of immune adjustment therapy can shorten the course of treatment and improve the cure rate.