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目的 研究SARS患者红细胞天然免疫黏附功能 (erythrocyteinnateimmuneadhesionfunction ,EIIAF)的变化及与红细胞CR1数量、循环补体C3、C4及免疫复合物含量等变化之间的关系 ,探讨引起EIIAF变化的可能原因。方法 EIIAF检测 :将 10 0 μl枸橼酸钠抗凝的待测病人血浆和 1μl离心沉淀红细胞 ,直接加到 15 0 μl定量分装的靶细胞管中 ,充分混匀 ,37℃水浴 30min ,结合 5个或以上红细胞的靶细胞为 1个黏附单位 ,计算黏附率。正常人血浆和红细胞与病人红细胞和血浆互换试验 :洗涤病人红细胞 ,与正常人血浆进行EIIAF检测 ,同时将正常人红细胞与病人血浆进行EIIAF检测作为对照。红细胞补体Ⅰ型受体 (CR1)定量测定 :采用细胞酶免法。补体C3、C4含量 ,采用免疫比浊法测定。循环免疫复合物采用凝集法。结果 6 5例SARS患者在出现发热等临床症状 1～ 3d内EIIAF即不同程度地下降 ,EIIAF的下降程度与患者发热、全身中毒症状及肺部炎症渗出的程度密切相关。重症SARS和因呼吸窘迫综合症死亡的患者其EIIAF接近完全消失 ;肺部阴影全部吸收时EIIAF回升到正常水平 ,并一过性地高于自身正常水平 ,然后再有不同程度的下降。正常人红细胞在SARS病人血浆中的EIIAF明显受到抑制 ,病人红细胞在正常人血浆中的EIIAF无明显回升。?
Objective To investigate the relationship between the changes of erythrocyte mortem immunoadhesionfunction (EIIAF) and the number of erythrocyte CR1, the contents of circulating complement C3, C4 and immune complex in patients with SARS, and to explore the possible causes of EIIAF. Methods EIIAF test: 10μl of sodium citrate anticoagulant patient plasma and 1μl of centrifuged precipitated erythrocytes, directly added to 15 0 μl quantitatively labeled target cell tube, thoroughly mixed, 37 ℃ water bath 30min, combined 5 or more target cells of red blood cells as an adhesion unit, calculate the adhesion rate. Normal human plasma and erythrocytes and patients with red blood cells and plasma exchange test: patients with washed red blood cells, normal human plasma EIIAF detection, and normal human erythrocytes and plasma EIIAF test as a control. Erythrocyte complement type Ⅰ receptor (CR1) quantitative determination: the use of cell-free enzyme method. Complement C3, C4 content, using the immune turbidimetric assay. Cyclic immune complexes using agglutination. Results Sixty-five cases of SARS patients experienced fever and other clinical symptoms within 1 to 3 days EIIAF decreased to varying degrees, EIIAF degree of decline and patient fever, systemic poisoning symptoms and lung inflammation exudation are closely related. EIIAF almost completely disappeared in patients with severe SARS and those who died of respiratory distress syndrome. EIIAF returned to normal levels when the total absorption of the lung shadow, and transiently higher than their normal level, and then decreased to some extent. The normal human erythrocytes EIIAF in the plasma of patients with SARS was significantly inhibited, the patient erythrocytes EIIAF in normal plasma no significant recovery. ?