严重急性呼吸综合征患者淋巴细胞变化的特征及意义

为研究严重急性呼吸综合征(SARS)病人外周血中淋巴细胞数量的变化规律,回顾性分析SARS患者不同时期外周血中的淋巴细胞数量。结果轻症SARS患者发病前2周时间内,淋巴细胞计数降低,从发病第3周开始,血中淋巴细胞水平升高。重症SARS患者在发病后1个月内淋巴细胞水平降低,未发现回升。在疾病的初发期、加重期、恢复期轻症与重症、轻症与死亡、重症与死亡之间比较,无显著性差异。根据病情变化分4期病情初发期(0期),胸片加重期(1期),开始吸收期(2期),胸片明显吸收期(3期),其中0期与3期、1期与3期比较有显著性差异。依糖皮质激素的使用分为小剂量组(Ⅰ组,<160mg/d),中剂量组(Ⅱ组,160～500mg/d),大剂量组(Ⅲ组,>500～1000mg/d),其中Ⅰ组与Ⅱ组、Ⅰ组与Ⅲ组之间比较有显著性差异。结果提示外周血中淋巴细胞的降低可以作为SARS早期诊断的一个指标,而血中淋巴细胞的回升预示疾病的好转。中、大剂量比较激素对SARS病人外周血中的淋巴细胞有明显抑制作用。

Characteristics of Peripheral Lymphocyte in Patients with Severe Acute Respiratory Syndrome

The objective was to study the peripheral lymphocyte in patients with severe acute respiratory syndrome(SARS).The lymphocyte in peripheral blood at different stage of SARS was investigated retrospectively.Results:In the mild group,lymphopenia was found in the first two weeks of onset,and a recovery from the third week.In the severe group,lymphopenia was sustained for four weeks,and recovering was not found in four weeks.At onset,exacerbating and recovering stage,comparisons of the lymphocyte between mild/severe,mild/dead,severe/dead had no significant difference.According to the state of the illness,patients were divided into four groups including the onset stage,X-ray exacerbating stage,first period of absorption,last period of absorption.The lymphocyte was significantly different between the onset stage and lost period of obsorption,X-ray exacerbating stage and last period of absorption.The lymphocyte decreased remarkably with mild dosage(160～500mg/d),and large dosage(>500～1000mg/d)of glucocorticoid.The lymphopenia in peripheral blood can be considerd as a criterion of SARS in the earlier stage diagnosis.The recovery of lymphocyte count in peripheral blood may indicate the improvement of illness.The lymphocyte decreases remarkebly by glucocorticoid(dose of>160mg/d).