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目的探讨肾综合征出血热(hemorrhagicfeverwithrenalsyndrome,HFRS)患者CD178+T淋巴细胞的本质及其在致病过程中的作用。方法应用流式细胞仪(flowcytometry,FCM)对56份HFRS患者外周血标本进行检测,分析CD178在HFRS淋巴细胞亚群和活化淋巴细胞中的表达及其动态变化。结果HFRS发热期和多尿期CD4+CD178+及CD8+CD178+T淋巴细胞与对照组比较明显增加,差异具有统计学意义。HFRS发热期和多尿期CD178在CD4+HLADR+T淋巴细胞群及CD8+HLADR+T淋巴细胞群表达均明显增高,与正常对照组比较,差异具有统计学意义;而发热期与多尿期之间比较,差异无统计学意义。结论HFRS的发病过程中CD178表达于活化CD4+淋巴细胞亚群,主要表达于CD8+T细胞亚群,且病程早期和后期均有高表达。推测在发病早期细胞毒T细胞(cytotoxicTlymphocyte,CTL)通过CD178介导的细胞调亡清除病毒感染的靶细胞,在疾病末期则通过清除活化的抗原特异性T细胞,维持机体免疫自身的稳定。
Objective To investigate the nature of CD178 + T lymphocytes in patients with hemorrhagicfeverwithrenals syndrome (HFRS) and their role in the pathogenesis. Methods Peripheral blood samples from 56 patients with HFRS were detected by flowcytometry (FCM). The expression and dynamic changes of CD178 in HFRS lymphocyte subsets and activated lymphocytes were analyzed. Results The HFRS fever period and polyuria period CD4 + CD178 + and CD8 + CD178 + T lymphocytes were significantly increased compared with the control group, the difference was statistically significant. HFRS fever and polyuria CD178 in CD4 + HLADR + T lymphocyte population and CD8 + HLADR + T lymphocyte population were significantly increased, compared with the normal control group, the difference was statistically significant; and fever period and polyuria Between the comparison, the difference was not statistically significant. Conclusion The expression of CD178 on activated CD4 + lymphocyte subsets during the pathogenesis of HFRS is mainly expressed in the subpopulation of CD8 + T cells, and both are highly expressed in the early and late stages of HFRS. It is speculated that cytotoxic T lymphocytes (CTLs) clear virus-infected target cells through CD178-mediated apoptosis during the early stages of disease, and maintain the body’s immune self-stability by eliminating activated antigen-specific T cells at the end of the disease.