不同巨细胞病毒感染患者的外周血淋巴细胞亚群分析

Analysis of peripheral blood lymphocyte subsets in patients with different cytomegalovirus infection status

目的探讨不同巨细胞病毒(cytomegalovirus,CMV)感染状态患者的外周血淋巴细胞亚群特点。方法选取2016年6月至2023年1月北京协和医院的住院CMV感染患者139例,分析不同CMV感染状态患者的外周血淋巴细胞亚群的变化特点,采用多因素logistic回归方程分析CMV病的影响因素。结果139例患者中男68例、女71例,年龄16~90岁,平均(51.0±18.0)岁,其中CMV病72例、亚临床CMV感染42例、潜伏性CMV感染25例。CMV病患者的血浆CMV-DNA载量显著高于亚临床CMV感染和潜伏性CMV感染患者,差异有统计学意义(P<0.05)。与亚临床CMV感染和潜伏性CMV感染患者相比,CMV病患者外周血淋巴细胞计数显著降低,差异有统计学意义(P<0.05)。多因素logistic回归分析结果显示,合并多重感染(OR=9.783,95%CI:1.964~48.729,P=0.005)、CD8+CD38+/CD8+升高(OR=1.047,95%CI:1.003~1.093,P=0.034)的患者发生CMV病的风险较高。结论CMV病患者存在明显的免疫功能紊乱,多重感染、CD8+CD38+细胞显著激活是CMV病的危险因素。当患者出现多重感染、CD8+CD38+/CD8+比例显著升高时需要警惕CMV病的发生。

Objective To explore the characteristics of peripheral blood lymphocyte subsets in patients with different cytomegalovirus(CMV)infection status.Methods A total of 139 inpatients with CMV infection in Peking Union Medical College Hospital from June 2016 to Janurary 2023 were selected,the characteristics of changes in peripheral blood lymphocyte subsets in patients with different CMV infection status were analyzed,and the multivariate logistic regression equation was used to analyze the influencing factors of CMV disease.Results Among the 139 patients,there were 68 males and 71 females,aged from 16 to 90 years,with an average age of(51.0±18.0)years.There were 72 cases of CMV disease,42 cases of subclinical CMV infection and 25 cases of latent CMV infection among the patients.The plasma CMV DNA load of patients with CMV disease group were significantly higher than those of patients with subclinical infection and latent CMV infection,and the differrences were statistical significant(P<0.05).Compared with patients with subclinical CMV infection and latent CMV infection,the number of peripheral blood lymphocytes in patients with CMV disease were significantly lower,with statistical significance(P<0.05).Multivariate logistic regression analysis results showed that patients with multiple infections(OR=9.783,95%CI:1.964-48.729,P=0.005)and increased CD8+CD38+/CD8+(OR=1.047,95%CI:1.003-1.093,P=0.034)were more likely to develop CMV disease.Conclusions There are obvious immune dysfunction in patients with CMV disease.Multiple infections and significant activation of CD8+CD38+were risk factors for CMV disease.When patients have multiple infections and CD8+CD38+/CD8+increases significantly,we need to be alert to the occurrence of CMV disease.