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目的研究严重急性呼吸综合征(severeacuterespiratorysyndrome,SARS)患者病程中各免疫学指标的变化与患者影像学表现的相关性,阐明患者影像学改变的免疫学基础。方法收集、整理2003年3月至7月期间在北京非典型肺炎定点医院确诊SARS患者临床资料,建立SARS病历数据库。其中病历完整的为1291例,记录SARS患者发病1～5周的白细胞、CD3、CD4、CD8阳性淋巴细胞绝对值、血沉、C反应蛋白以及患者的影像学发现的病变范围等数据,研究SARS患者各免疫学指标的变化与影像学病变范围的相关性并进行统计学分析。结果影像学病变范围广的SARS患者白细胞、CD3、CD4、CD8阳性淋巴细胞比病变范围小的患者明显减少(P<0.05),病变范围广者炎症指标升高明显(P<0.05)。影像学表现随时间变化,并且与白细胞、CD、CD、CD阳性淋巴细胞的变化同步。结论影像学表现与免疫指标变化有时间的一致性。
Objective To study the correlation between the changes of immunological indexes in patients with severe acute respiratory syndrome (SARS) and the imaging features of patients and to clarify the immunological basis of the imaging changes. Methods The clinical data of patients with SARS diagnosed at the SARS designated hospital in Beijing from March to July 2003 were collected and collected, and a SARS medical record database was established. Among them, there were 1291 cases with complete medical record. The absolute values of white blood cells, CD3, CD4, CD8 positive lymphocytes, erythrocyte sedimentation rate and C-reactive protein in patients with SARS and the range of lesions were recorded. The patients with SARS The correlation between the changes of immunological indexes and the scope of the imaging lesions and statistical analysis. Results The number of white blood cells, CD3, CD4 and CD8 positive lymphocytes in patients with SARS with a wide range of imaging lesions were significantly lower than those with smaller lesions (P <0.05). The inflammation index was significantly higher in a wide range of patients with SARS (P <0.05). Imaging findings changed over time and were synchronized with leukocyte, CD, CD, CD positive lymphocyte changes. Conclusion The imaging findings and immune index changes have time consistency.