新型冠状病毒复阳病例临床特征、实验室检查与T淋巴细胞亚群功能研究

Study on the clinical characteristics,laboratory tests and the function of T lymphocyte subsets of SARS-CoV-2 in re-detectable positive cases

目的研究新型冠状病毒(SARS-CoV-2)复阳的危险因素。方法对16例单中心SARS-CoV-2复阳病例(复阳组)的临床特征和实验室检查结果进行回顾性分析。比较复阳组和对照组(20例)血常规、T淋巴细胞亚群的差异。结果复阳患者主要症状为间断咳嗽、咽喉痛,12.50%(2/16)的患者患有慢性基础性疾病,31.25%(5/16)的患者为乙型肝炎病毒携带者,25.00%(4/16)的患者患有进行性淋巴细胞减少症,12.50%(2/16)的患者出现肝功能异常。与上次出院计算机断层扫描(CT)影像比较,复阳患者中3例完全吸收,4例明显吸收,5例部分吸收,1例少许吸收,3例略吸收。复阳患者中,轻型组(3例)和普通型组(13例)的淋巴细胞百分率、淋巴细胞计数、CD3+淋巴细胞计数、CD4+淋巴细胞计数明显低于对照组,差异均有统计学意义(P<0.05);2组白细胞计数、中性粒细胞与淋巴细胞比值(NLR)、中性粒细胞计数、CD8+淋巴细胞计数比较差异均无统计学意义(P>0.05)。结论SARS-CoV-2复阳有迹可循,但临床表现无特异性,需要密切关注复阳患者宿主本身状态和机体免疫细胞功能。

Objective To study the risk factors of SARS-CoV-2 rejuvenation.Methods The clinical characteristics and laboratory test results of 16 single-center SARS-CoV-2 re-detectable positive cases(re-detectable positive group)were retrospectively analyzed.The differences in blood routine and T lymphocyte subsets between the re-detectable positive group and the control group(20 cases)were compared.Results The main symptoms of re-detectable positive patients are intermittent cough and sore throat.12.50%(2/16)of the patients had chronic underlying diseases.31.25%(5/16)of the patients were carriers of hepatitis B virus.25.00%(4/16)of the patients had progressive lymphopenia.12.50%(2/16)of the patients had abnormal liver function.Compared with the computed tomography(CT)image of the last discharge,3 cases of re-detectable positive patients completely absorbed,4 cases had obvious absorption,5 cases had partial absorption,1 case had little absorption,and 3 cases had slight absorption.Among re-detectable positive patients,the lymphocyte percentage,lymphocyte count,CD3+lymphocyte count,CD4+lymphocyte count in the mild group(3 cases)and the normal group(13 cases)was significantly lower than that in the control group,and the differences were statistically significant(P<0.05).There was no significant difference in white blood cell count,NLR,neutrophil count,CD8+lymphocyte count between the two groups(P>0.05).Conclusion SARS-CoV-2 has traces to follow,but the clinical manifestations are not specific.It is necessary to pay close attention to the host′s own status and immune cell function in patients with re-detectable positive.