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252例SARS患者T淋巴细胞亚群动态改变与病情变化的相关性分析
Analysis of Relationship Between Dynamic Change of T-lymphocyte Subpopulations and Clinical Progression in SARS Patients
【摘要】 目的 研究SARS患者T淋巴细胞亚群的动态变化规律 ,探索SARS特异性早期诊断的指标 ,寻找SARS的病情发展的预警指标 ,为研究SARS发病机制提供依据。方法 收集我院SARS确诊病人 2 5 2例患者的抗凝血 ,用特异性荧光抗体标记 ,通过FACS流式细胞仪检测CD4,CD3 ,CD8,NK ,CD4/CD8。每 3~ 5d复查 1次 ;比较不同病情及病程不同阶段时 ,上述指标的变化及相关关系。结果 所有的SARS患者在病程的第 1,2周 ,均有CD4,CD3 ,CD8,下降 ,在第 2周时降至最低 ,尤其以CD4下降最明显 ,在第 3周开始回升。重型患者CD4,CD3 ,CD8的变化规律与轻型相同 ,但下降程度更严重 ,持续时间更长。CD4+ 淋巴细胞计数在轻型患者病程第一周为 5 15± 44 4/μl ,第二周 42 1± 3 5 0 /μl ,第 3周为 60 0± 3 89/μl ,各周间差异均有显著性 ( P <0 0 5 ) ,第 4周为 773± 45 6/μl ,恢复至正常水平。在重型患者的病程第一周为 3 12± 15 8/μl,第二周 2 5 5± 187/μl,( P >0 0 5 ) ,在第三周回升为 43 5± 3 43 /μl ,第 4周5 3 9± 3 94/μl,仍未恢复至正常。NK细胞在发病期间亦有所下降 ,但其水平波动不大。CD4/CD8在整个发病过程中变化不大 ,基本在正常水平。结论 CD4,CD3 ,CD8等淋巴细胞亚群减少是早期诊断的敏感指标 ,也是病情加?
【Abstract】 Objective To investigate the dynamic change of T-lymphocyte subpopulations in the patients with SARS to understand the pathogenesis of SARS,and to find the specific early diagnostic and warning indexes for SARS.Methods T-lymphocytes in the peripheral blood were labelled by specific fluorescein antibodies and examined by flow cytometry in 252 cases of patients with SARS.The relationship between the dynamic change of T-lymphocyte subpopulations and the clinical progression was analyzed.Results The CD 3 +,CD 4 + and CD 8 + T cells,especially CD 4 + T cells decreased at the fist two-week of the disease course and reached to the lowest level at the second week,and began to increase from the third week in all patients.The change pattern of CD 3 +,CD 4 + and CD 8 + T cells in the severe type of SARS was the same as that of the mild type of SARS,but with more serious extent and longer time.The CD 4 + cell amount of the first,second and third weeks in the mild type of SARS was 515±444/μl,421±350/μl and 600±389/μl respectively,and was up to normal level at the fourth week.The CD 4 + cell amount of the first,second,third and fourth weeks in the severe type of SARS was 312±158/μl,255±187/μl,435±343/μl and 539±394/μl respectively,and still lower than normal level at the fourth week.There was a significant difference in the CD 3 +,CD 4 + and CD 8 + cell amount among the different weeks of disease course in both types.NK cell amount also decreased during the course of disease.The CD 4 +/CD 8 + ratio did not change much and was within the normal range.Conclusions The decrease of CD 3 +,CD 4 + and CD 8 + T cells is a sensitive index for early diagnosis of SARS.The continuous decrease of them may indicate the severe condition of the patients with SARS.
- 【文献出处】 中国医师杂志 ,Journal of Chinese Physician , 编辑部邮箱 ,2003年10期
- 【分类号】R511.9
- 【被引频次】11
- 【下载频次】90