淋巴细胞亚群在新型冠状病毒肺炎患者外周血中的表达及临床意义

Expression of lymphocyte subsets in peripheral blood of patients with novel coronavirus pneumonia and its clinical significance

目的探讨淋巴细胞亚群在新型冠状病毒肺炎(COVID-19)患者外周血中的表达及临床意义。方法选取2020年1月18日至2月25重庆市长寿区人民医院收治的25例新型冠状病毒(SARS-CoV-2)核酸检测为阳性的患者为研究对象,其中21例有临床症状、确诊为COVID-19的患者为COVID-19组;4例无临床症状但SARS-CoV-2核酸检测为阳性的患者为无症状感染组;选取同期体检的20例健康者为对照组。检测各组淋巴细胞亚群,分析各组不同淋巴细胞水平的差异。结果21例COVID-19患者中,18例患者的总淋巴细胞计数(Lym#)低于参考区间下限,3例患者的Lym#在正常参考区间内;20例患者的自然杀伤细胞计数(NK#)低于参考区间下限,1例患者的NK#在参考区间内。COVID-19组T淋巴细胞百分比、B淋巴细胞百分比高于对照组(P<0.05),NK细胞百分比(NK%)、Lym#、T淋巴细胞计数、CD4+T淋巴细胞计数、CD8+T淋巴细胞计数、NK#低于对照组(P<0.05)。COVID-19组NK#及NK%低于无症状感染组(P<0.05)。结论COVID-19患者存在淋巴细胞亚群水平异常,其中NK细胞下降显著;COVID-19组、无症状感染组与健康组淋巴细胞亚群水平存在差异,提示淋巴细胞亚群在COVID-19的诊断、病情评估中可能具有一定的临床价值。

Objective To investigate the expression and clinical significance of lymphocyte subsets in the peripheral blood of patients with corona virus dosease 2019(COVID-19).Methods A total of 25 patients who tested positive for the severe acute respiratory syndrome coronavirus 2(SARS-CoV-2)nucleic acid tested in People′s Hospital of Chongqing Changshou District from January 18 to February 25,2020 were selected as the research objects.Among them,21 patients with clinical symptoms and confirmed as COVID-19 were included in the COVID-19 group,4 patients with no clinical symptoms but positive with the SARS-CoV-2 nucleic acid test were included in the asymptomatic infection group,and 20 healthy patients who received physical examination during the same period were selected as control group.The lymphocyte subgroups of each group were detected and the differences in the levels of lymphocyte subgroups in each group were analyzed.Results Among the 21 COVID-19 patients,the total lymphocyte count(Lym#)of 18 patients was lower than the lower limit of reference interval,the Lym#of 3 patients was within the lower limit of reference interval;the natural killer cell count(NK#)of 20 patients was lower than the reference interval,and 1 patient′s NK#was within the normal reference interval.The percentage of T lymphocytes and B lymphocytes in the COVID-19 group were higher than those of the control group(P<0.05),NK cell percentage(NK%),Lym#,T lymphocyte count,CD4+T lymphocyte count.The CD8+T lymphocyte count and NK#were lower than those in the control group(P<0.05).The NK#and NK%in the COVID-19 group were lower than those in the asymptomatic infection group(P<0.05).Conclusion The levels of lymphocyte subsets in COVID-19 patients are abnormal,among which NK cells decrease significantly.There are differences in the levels of lymphocyte subsets in the COVID-19 group,asymptomatic infection group and healthy control group,suggesting that the lymphocyte subsets may have certain clinical value in diagnosis and disease assessment in COVID-19.