【摘要】 目的探讨严重急性呼吸综合征(SARS)患者T淋巴细胞亚群在病程中的动态变化规律。方法对广东省SARS数据库中所有检测过外周血T淋巴细胞亚群的292例SARS患者,按疾病进程、预后及是否使用激素,对SARS患者外周血T淋巴细胞亚群的动态变化作回顾性分析。结果SARS组T淋巴细胞计数显著低于健康对照组(P<0.01),低谷出现于病程第5～10d。其中256例治愈SARS患者在病程第10～15d开始明显回升,多数恢复正常;36例死亡SARS患者外周血T细胞亚群计数持续降低,CD4+、CD8+均低于250个/μl。SARS患者是否使用激素在病程16天内对T细胞计数有显著性差异(P<0.01),病程第17天上述计数无显著性差异,且使用激素组较未使用激素组T细胞亚群计数推迟8d左右回升至正常水平。结论SARS患者外周血T细胞亚群计数均显著下降,下降程度可作为病情轻重及预后判断的重要指标,而激素使用可加重SARS患者的免疫抑制。更多还原

【Abstract】 Objective To investigate the dynamic changes of T-lymphocyte subsets in patients withsevere acute respiratory syndrome(SARS) of GuangDong. Method The dynamic changes of T-lymphocytesubsets of peripheral blood in 292 patients with SARS were analyzed retrospectively, according totheir illness process and prognosis and therapy with or without glucocorticoid, all data are come fromSARS database of Guangdong province. Result T-lymphocyte count of peripheral blood in SARS group wassignificantly lower than that in healthy control group(P<0.01), a low ebb appeared from the fifth dayto tenth day of course of disease, T-lymphocyte count in 256 alive cases ascended significantly fromthe 10th to 15th day of course of disease, most of them recovered; T-lymphocyte count in 36 dead casesdegraded persistantly, both CD4+ and CD8+ T-lymphocyte count are lower than 250/ μ l, therapy withsteroid hormone before 16th day of course of disease can significantly affect T-lymphocyte count(P<0.01), therapy with glucocorticoid after 17th day of course of disease, T-lymphocyte count is notsignificance difference between two groups, and the ascend of T-lymphocyte count in patients who weretreated with glucocorticoid were delayed 8 days than ones who were treated without glucocorticoid.Conclusion T-lymphocytes count in patients with SARS decreased significantly, the degree ofdecreasing can be a important index to estimate patient’s condition and judgemen prognosis,and therapywith glucocorticoid may aggravation immunosuppression.更多还原