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目的 探索外周血淋巴细胞亚群在严重急性呼吸综合征(SARS)患者病程中的动态变化。方法 采用流式细胞测定法对240例确诊为SARS患者外周血淋巴细胞及其亚群的绝对计数进行测定,并对不同组别SARS患者与正常对照组比较。结果 SARS患者的淋巴细胞及其亚群(CD45、CD3、CD4、CD8)的绝对计数分别为1298±785、897±606、510±372、362±263个/mm~3,明显低于正常对照组(2024±423、1391±289、795±129、551±183个/mm~3);重型(极重型)患者(1095±740、740±562、419±346、304±244个/mm~3)低于普通型(1404±788、991±612、564±378、396±267个/mm~3);死亡组(587±493、369±371、204±191、150±130个/mm~3)低于治愈组(1355±776、948±603、539±375、382±263个/mm~3);普通型与重型(极重型)以及治愈组与死亡组患者之间淋巴细胞亚群(CD45、CD3、CD4、CD8)绝对计数差异有显著统计学意义(P<0.01),但不同组别间 CD4/CD8比值比差异无显著性(P>0.05)。SARS患者的淋巴细胞亚群(CD45、CD3、CD4、CD8)计数于病程第1周即开始下降,第2周降至最低水平(977±579、641±466、360±275、270±216个/mm~3),然后随病情恢复而逐渐上升。结论 测定SARS患者外周血淋巴细胞及其亚群可作为判断病情轻重和疾病预后的方法之一。
Objective To explore the dynamic changes of peripheral blood lymphocyte subsets in patients with severe acute respiratory syndrome (SARS). Methods The absolute counts of peripheral blood lymphocytes and their subgroups in 240 patients diagnosed as SARS were determined by flow cytometry. The SARS patients of different groups were compared with the normal control group. Results The absolute counts of lymphocytes and their subgroups (CD45, CD3, CD4, CD8) of SARS patients were 1298 ± 785, 897 ± 606, 510 ± 372 and 362 ± 263 / mm ~ 3, respectively, (2024 ± 423, 1391 ± 289, 795 ± 129, and 551 ± 183 / mm ~ 3). The patients with severe type (1095 ± 740, 740 ± 562, 419 ± 346, 304 ± 244 / 3) were lower than the common type (1404 ± 788,991 ± 612,564 ± 378,396 ± 267 / mm ~ 3); those in the death group (587 ± 493,369 ± 371,204 ± 191,150 ± 130 / mm ~ 3) lower than the cure group (1355 ± 776,948 ± 603,539 ± 375,382 ± 263 / mm ~ 3); common type and heavy (very heavy) and the cure and death patients between lymphocyte sub There were significant differences in absolute counts of CD45, CD3, CD4, CD8 (P <0.01), but there was no significant difference in CD4 / CD8 ratio among different groups (P> 0.05). The counts of lymphocyte subsets (CD45, CD3, CD4, CD8) in patients with SARS began to decrease from the first week of disease course to the lowest level in the second week (977 ± 579,641 ± 466,360 ± 275,270 ± 216 / mm ~ 3), and then gradually increased with the recovery of the disease. Conclusion The determination of peripheral blood lymphocytes and their subpopulations in patients with SARS can be used as one of the methods to judge the severity and prognosis of the disease.