SARS患者淋巴细胞亚群和Th1/Th2细胞因子的检测与意义

Measurement of the T Lymphocyte Subsets and the Th1/Th2 Cytokines in Patients with Severe Acute Respiratory Syndrome

为了解SARS患者糖皮质激素治疗后细胞免疫状况 ,系列观察我院 7例SARS确诊者 (5男 2女 ,2 8～ 6 8岁 )淋巴细胞亚群及细胞因子变化 ,病程 0～ 6 1d。另选 31例HIV感染者作疾病对照 ,2 4例健康献血员作正常对照。用流式细胞术检测外周血CD3、CD4和CD8细胞 ,以ELISA法检测血清Th1/Th2类细胞因子 (IFN γ/IL 4 )含量。结果是SARS组CD3、CD4、CD8均值 (5 2 9 80、 313 0 9、 195 94 /μl)都低于正常组均值 (14 2 0 95、 80 9 80、 5 30 95 /μl) ,P均 <0 0 0 1;与HIV组均值(813 2 3、 176 81、 6 0 3 10 /μl)比较 ,CD4、CD8偏低 (P <0 0 0 6、P <0 0 0 1)。SARS组CD4 /CD8比值与正常组相比 ,差异不显著。淋巴细胞亚群数目与病程密切相关。SARS组Th1/Th2类细胞因子水平 (A均值 0 0 5 8/0 0 31)均低于HIV组 (A均值0 0 79/0 0 33)和正常组 (A均值 0 111/0 0 35 ) ,细胞因子含量与病程无关。提示我们所观察的SARS患者细胞免疫功能低下。

To evaluate the status of cell mediated immunity of patients with severe acute respiratory syndrome (SARS),the changes of T lymphocyte subsets and the Th1/Th2 cytokines in 7 cases of SARS in Shanghai (5 males and 2 females age 28～68,course of disease 0～61 days) and 31 cases of HIV-infected individuals taken as controls,were investigated in the present study. The CD3 +,CD4 + and CD8 + T lymphocytes in the peripheral blood were analyzed with flow cytometry and the Th1/Th2 cytokonies (IFN-γ/IL-4) in serum were tested by ELISA assay. It was found that the average numbers of CD3 +,CD4 + and CD8 +T cells in cases of SARS were decreased (529.80,313.09,195.94/μl) in comparison with those of the normal controls (1 420.95,809.80,530.95/μl). A decrease in the numbers of CD4 and CD8 T subsets in cases with SARS was also observed in comparison with those of the HIV-infected individuals (813.23,176.81,603.10/μl),but the CD4/CD8 ratio in case of SARS was unchanged. There existed a close correlation between the counts of T lymphocytes and course of illness. The levels of Th1/Th2 cytokines in cases of SARS were significantly decreased compared with those of the normal controls,and even lower than those in the HIV-infected individuals. The content of cytokines was not correlated with the course of illness. It concludes that the cell-mediated immunity in patients with SARS is depressed.