严重急性呼吸综合征患者T淋巴细胞亚群动态变化与病情关系

The dynamic change of the subgroups of T-lymphocyte and its relationship to severity of illness in severe acute respiratory syndrome patients

目的 :研究严重急性呼吸综合征 (SARS)患者T淋巴细胞动态变化的特点 ,探讨其意义。方法 :收集我院 2 0 0 3年 2—4月收治的 36例SARS确诊病例与 6 4例健康者的抗凝血 ,用特异性荧光抗体标记 ,通过流式细胞仪检测其T淋巴细胞亚群的动态改变 ,并与临床病情的动态变化进行比较。结果 :SARS患者T淋巴细胞亚群CD3、CD4、CD8计数均较正常人明显降低 ,且重症组患者较普通组患者下降更显著 (P <0 .0 1)。随着病程进展 ,普通组患者T淋巴细胞亚群CD3、CD4、CD8绝对计数尤其CD4能较快恢复 ,预后良好 ,重症组患者T淋巴细胞亚群CD3、CD4、CD8绝对计数恢复慢、病情多加重。结论 :机体细胞免疫损伤可能是本病发生的重要机制之一。SARS患者外周血T淋巴细胞亚群计数的动态变化 ,尤其是CD4改变 ,对病情预后判断有重要参考价值。

Objective: To investigate the dynamic change of the subgroups of T-lymphocytes for the understanding the pathogenesis of severe acute respiratory syndrome (SARS) . Methods:36 patients with confirmed SARS hospitalized from February to April in 2003 were enrolled and compared with 64 healthy subjects. Blood samples drawn in different courses of SARS were labeled with specific fluorescent antibody, subgroups of T-lymphocytes were counted by flow cytometer. Results:The counted number of subgroups of T-lymphocyte CD3, CD4 and CD8 in SARS patients were significantly lower than that in healthy subjects, and were statistically significantly lower in severe patient group comparing with mild to moderate severe patients (P< 0.01 ). In mild to moderate severe patient group, the absolute number of subgroups of T-lymphocytes CD3、CD4 and CD8, especially CD4, recovered quickly along with recovery of the disease and prognosis were usually good. While in severe patient group, the absolute number of subgroup CD3、CD4 and CD8 recovered slowly and the patients were usually exacerbated. Conclusions:Immunological injury of the host may play an important role in the pathogenesis of SARS. The dynamic change of the number of subgroups of the T-lymphocytes in peripheral blood, especially the number of CD4, can be used as an indicator predicting the prognosis of SARS.