SARS患者急性期与恢复期红细胞天然免疫黏附功能的变化

Erythrocyte innate immune adhesion function at acute and convalescence phase in SARS patients

目的 :研究严重急性呼吸综合征 (SARS)患者急性期和恢复期红细胞天然免疫黏附功能 (erythrocyte innate imm uneadhesion function,EIIAF)的变化及意义。 方法 :采用 EIIAF快速检测方法 ,将 10 0 μl枸橼酸钠抗凝的待测患者血浆和 1μl离心沉淀红细胞 ,直接加到 15 0 μl定量包装的靶细胞管中 ,充分混匀 ,37℃水浴 30 min,结合 5个或以上红细胞的靶细胞为 1个黏附单位 ,计算黏附率。同时 ,采用细胞酶免疫分析法测定红细胞膜补体 1型受体 (com plem entreceptor type1,CR1)数量。结果 :临床诊断为 SARS的 4 7例患者 ,在急性期 EIIAF皆显著下降 (P<0 .0 1) ,部分患者降至正常人群水平的 5 0 %左右 ,因衰竭而死亡的 SARS患者死亡前 EIIAF接近消失 ;病情恢复并出院的 SARS患者 EIIAF全部恢复至正常水平 (部分患者在恢复早期可显著高于正常水平 )。SARS患者 EIIAF的下降与红细胞膜 CR1数量下降基本平行。结论 :对 SARS患者进行 EIIAF动态检测 ,可有效评估 SARS病情变化 ,同时有助于对

Objective:To study the changes and significance of erythrocyte innate immune adhesion function (EIIAF) in SARS patients at acute and convalescence phase. Methods:The assay of EIIAF was done as following: One microliter red blood cells and 100 μl plasma of SARS patient was mixed with 150 μl quantitative target antigen cells at 37℃ for 30 min. One tumor cell attached by 5 erythrocytes or more was counted as 1 adhering unit, and the ratio of units was calculated. The quantitative expression of complement receptor type 1(CR1) on erythrocyte was analyzed by ELISA. Results:The EIIAF in 47 SARS patients was significantly lower than that of healthy controls( P <0.01) at acute phase. EIIAF was greatly decreased when the patient situation got worse and almost disappeared when died. However, EIIAF returned to or near the normal level when the patients recovered( t =2.02, P <0.05). EIIAF may remain abnormally higher than normal level on the first several days of recovery, then returned to normal levels. Conclusion:There is a good relation between EIIAF and the severity SARS. To detect the changes of EIIAF may be helpful in predicting the development and prognosis of SARS.