SARS患者的外周血淋巴细胞及其亚群动态变化

Dynamics of peripheral blood lymphocytes and their subpopulations in patients with severe acute respiratory syndrome

目的 探索外周血淋巴细胞亚群在严重急性呼吸综合征(SARS)患者病程中的动态变化。方法 采用流式细胞测定法对240例确诊为SARS患者外周血淋巴细胞及其亚群的绝对计数进行测定,并对不同组别SARS患者与正常对照组比较。结果 SARS患者的淋巴细胞及其亚群(CD45、CD3、CD4、CD8)的绝对计数分别为1298±785、897±606、510±372、362±263个/mm^3,明显低于正常对照组(2024±423、1391±289、795±129、551±183个/mm^3);重型(极重型)患者(1095±740、740±562、419±346、304±244个/mm^3)低于普通型(1404±788、991±612、564±378、396±267个/mm^3);死亡组(587±493、369±371、204±191、150±130个/mm^3)低于治愈组(1355±776、948±603、539±375、382±263个/mm^3);普通型与重型(极重型)以及治愈组与死亡组患者之间淋巴细胞亚群(CD45、CD3、CD4、CD8)绝对计数差异有显著统计学意义(P<0.01),但不同组别间 CD4/CD8比值比差异无显著性(P>0.05)。SARS患者的淋巴细胞亚群(CD45、CD3、CD4、CD8)计数于病程第1周即开始下降,第2周降至最低水平(977±579、641±466、360±275、270±216个/mm^3),然后随病情恢复而逐渐上升。结论 测定SARS患者外周血淋巴细胞及其亚群可作为判断病情轻重和疾病预后的方法之一。

Objective To study on the dynamics of peripheral blood lymphocytes and their subpopulations in patients with severe acute respiratory syndrome. Methods Using flow cytometry, the absolute numbers of peripheral blood lymphocytes and their subpopulations in 240 SARS patients (696 specimens) and 51 individuals as controls, were counted and compared. Results The absolute numbers of peripheral blood lymphocytes and their subpopulations(CD45, CD3, CD4, CD8) were 1298±785, 897± 606,510±372, 362±263/mm^3, respectively, significantly lower in SARS patients as compared to the normal controls (2024±423, 1391±289, 795±129, 551±183/mm^3). Of SARS patients, severe group (1095±740, 740±562, 419±346, 304±244/mm^3) had lower counts than that of mild group (1404± 788,991±612, 564±378, 396±267/mm^3), and in group with deaths (587±493, 369±371, 204±191, 150±130/mm^3) was lower than that of recovery group (1355±776, 948±603, 539±375, 382±263/ mm^3). There were significant differences(P< 0. 01) for CD45, CD3, CC4, CD8, but with no significant difference (P> 0. 05) for CD4/CD8 ratio between severe and mild, recovery and death groups. The lymphocytes and their subpopulations (CD45, CD3, CD4, CD8) declined in the 1st week and to the lowest level (977±579,641±466, 360±275,270±216/mm^3) in the 2nd week. Then the lymphocytes and their subpopulations gradually increased during the recovery of the disease. Conclusion The absolute numbers of peripheral blood lymphocytes and their subpopulations in SARS patients might be used as one of the methods for diagnosis on the severity and prognosis of the disease.