新型冠状病毒肺炎患者外周血淋巴细胞亚群的分析研究

Analysis of Peripheral Blood Lymphocyte Subsets in Patients with Novel Coronavirus Pneumonia

目的研究新型冠状病毒肺炎患者的淋巴细胞亚群的变化。方法选取2020年2月于重庆三峡中心医院就诊的轻型冠状病毒肺炎患者(轻型组)35例、重型冠状病毒肺炎患者(重型组)11例,以健康体检者(NC组)20例为对照组,通过流式细胞检测三组淋巴细胞总数、T淋巴细胞(CD4^(+)T,CD8^(+)T,CD4^(+)/CD8^(+))、B淋巴细胞数及NK细胞数量的变化。结果两组患者的淋巴细胞总数、T淋巴细胞数(比例)、CD4^(+)T细胞数(比例)、CD8^(+)T细胞数(比例)、B淋巴细胞数(比例)、NK细胞数(比例)的差异均有统计学意义(t=-0.774~0.121,P<0.05),且重症组比轻症组降低的更为显著,差异具有统计学意义(t=-0.852~1.208,均P<0.05);两组患者的CD8^(+)T细胞数和CD4^(+)/CD8^(+)较对照组有所升高(t=-0.142~0.256,P<0.05),但轻症组与重症组组间差异不明显,差异无统计学意义(P>0.05);两组患者B淋巴细胞数及B淋巴细胞比例较对照组显著升高(t=0.065,-0.352,P<0.05),且重症组明显高于轻症组(t=-0.744,-0.114,P<0.05),差异均有统计学意义;NK细胞比例在重症组可见明显升高(t=0.011,P<0.05),而在轻症组和对照组差异则无统计学意义(t=0.059~0.201,P>0.05)。结论新型冠状病毒肺炎患者存在免疫功能紊乱,患者机体细胞免疫水平降低,重症患者可见免疫监视水平升高。

Objective To study the changes of lymphocyte in patients with mild and severe 2019-ncov pneumonia.Methods In this study,45 patients with mild coronavirus pneumonia(mild group)and 11 patients with severe coronavirus pneumonia(severe group)were selected from Chongqing Three Gorges Central Hospital in February 2020,and 20 healthy subjects(NC group)were selected as controls,the changes of total lymphocyte,T-lymphocyte(CD4^(+)T,CD8^(+)T,CD4^(+)/CD8^(+)),B-lymphocyte number and NK cell number were measured by flow cytometry.Results There were statistically significant differences in the total number of lymphocytes,the number of T lymphocytes(proportion),the number of CD4^(+)T cells(proportion),the number of CD8^(+)T cells(proportion),the number of B lymphocytes(proportion),and the number of NK cells(proportion)between the two groups were statistically significant(t=-0.774~0.121,P<0.05),and the number of CD8^(+)T cells and CD4^(+)/CD8^(+)in the severe group was significantly lower than that in the mild group(t=-0.852~1.208,P<0.05).Compared with the control group,it was increased(t=-0.142~0.256,P<0.05),but there was no significant difference between the mild group and the severe group(P>0.05).The proportion of B lymphocyte in the two groups was significantly higher than that in the control group(t=0.065,-0.352,P<0.05),and the proportion of NK cells in the severe group was significantly higher than that in the mild group(t=0.011,P<0.05).There was no statistical significance(t=0.059~0.201,P>0.05).Conclusion Patients with novel coronavirus pneumonia have immune dysfunction,and their cellular immunity level is reduced,increased level of immune surveillance in severe patients.