SARS病人外周血T淋巴细胞的动态变化及其在发病进程和发病机理中的意义

The study of T lymphocyte in Severe Acute Respiratory Syndrome(SARS)

目的 :通过研究严重急性呼吸综合征 (SevereAcuteRespiratorySyndrome,SARS)患者外周血免疫细胞的动态变化 ,探讨外周血免疫细胞在SARS发病进程中的意义 ,初步探讨SARS的发病机理 ,并为SARS的诊断和治疗提供有力的实验室依据。方法 :回顾性动态观察我院收治的已治愈SARS病例和SARS死亡病例外周血CD4 + 和CD8+ T淋巴细胞 ,评估外周血免疫细胞在SARS发病进程及预后中的作用。实验方法为流式细胞术检测和分析免疫细胞表面特异性荧光抗体标记 ,T细胞表面标志组合为CD3 CD8 CD4 5 CD4。结果 :所有治愈的SARS病人的CD4 + 和CD8+ T淋巴细胞都有不同程度的可逆性下降 ,而所有的死亡病例有不可逆性显著下降 ,直至死亡。T细胞下降程度和维持的时间与病情密切相关。普通型SARS病例最低CD4 + T淋巴细胞数为 30 5± 15 0cells μl(P <0 .0 0 1)、重型为 139± 6 9cells μl(P <0 .0 0 1) ,普通型SARS病例最低CD8+ T淋巴细胞数为 2 2 3± 89cells μl(P <0 .0 0 1)、重型为 171± 92cells μl(P <0 .0 0 1)。所有普通型病例和大部分重型病例T淋巴细胞恢复正常 ,个别重型病例低于正常或接近正常 ,恢复后普通型平均为 991± 2 86cells μl,重型平均为 5 4 5± 2 2 5cells μl。恢复时间有所不同 ,普通型平均为 17±

Objective:To study the evalution of T lymphocyte in Severe Acute Respiratory Syndrome (SARS) patients.Methods:T lymphocyte in the peripheral blood was determined by Flow Cytometry in 53 patients with SARS. Results:The CD4 +T cell and CD8 +T cell decreased reversiblly in the cured SARS patients, but decreased progressively in the dead cases. The level and duration of the decrease are correlated with the patient's condition. The lowest CD4 +T cell count is 305±150 cells/μl(P<0.001) ,139±69 cells/μl(P<0.001) in the mild cases and severe cases during the course of disease, respectively. The lowest CD8 + cell count is 223±89 cells/μl (P<0.001),171±92 cells/μl (P<0.001)in the mild cases and severe cases. T cell counts were normalized in the mild cases and the major severe cases. But the time for T lymphocyte back to normal was significantly shorted and the counts was significantly higher in the mild cases(17±5 days,991±286 cells/μl, respectively) than in the severe cases(27±6 days,545±225 cells/μl, respectively).