淋巴结核患者外周血中T淋巴细胞亚群的检测及其意义

目的观察淋巴结核患者外周血CD3+T细胞、CD4+T细胞、CD8+T细胞、CD4+/CD8+比值变化,探讨其在结核病发生发展中的临床意义。方法采用流式细胞仪检测48例淋巴结核患者和60例健康体检者的T淋巴细胞亚群的水平,并进行对比分析。结果淋巴结核患者与对照组T淋巴细胞亚群比较,除CD8+T细胞增高外,CD3+T细胞、CD4+T细胞、CD4+/CD8+比值均低于对照组(P<0.05)。不同年龄、性别淋巴结核患者CD3+T细胞、CD4+T细胞、CD8+T细胞、CD4+/CD8+比值差异无统计学意义(P>0.05)。结论结核病的发病与外周血中T淋巴细胞亚群分布失衡相关,CD3+T细胞、CD4+T细胞、CD8+T细胞在免疫应答中起重要作用。     

传染性及非传染性非典型肺炎患者外周血T淋巴细胞亚群变化及临床意义

我院于2003年2月至5月承担了广州市SARS的收治工作，现就其外周血T淋巴细胞亚群进行的检测及动态观察结果，分析如下。     

外周血T淋巴细胞亚群检测对乙型肝炎患者的意义

目的观察乙型肝炎患者外周血T淋巴细胞亚群的表达,并研究其变化及其临床意义。方法对我院60例乙型肝炎患者和同期40例健康者采取流式细胞分析技术检测外周血T淋巴细胞亚群的改变。结果在不同临床类型的慢性乙型肝炎中,CD3 、CD4 、CD8 、CD4 /CD8 明显低于正常对照组(P<0.05),而急性肝炎中差异无统计学意义(P>0.05)。结论通过检测T淋巴细胞亚群的数值变化,为临床上准确使用干扰素等免疫调节剂提供依据,并能在监测疾病的发展情况、病毒复制状态、预测预后及对临床上乙肝的治疗、有无慢性化倾向起到指导作用。     

恶性肿瘤患者外周血T淋巴细胞亚群分析

目的探讨恶性肿瘤患者外周血T淋巴细胞亚群的分布特点。方法采用流式细胞术分析比较80例恶性肿瘤患者及40例健康对照组的外周血T淋巴细胞亚群。结果恶性肿瘤患者存在免疫受抑制情况,CD3+、CD4+T淋巴细胞百分率明显减少,与对照组比较差异有统计学意义(P0.05)。CD8+T淋巴细胞百分率升高,CD4+/CD8+比值降低,与对照组比较有差异有统计学意义(P0.05)。结论恶性肿瘤患者外周血T淋巴细胞亚群异常,监测其T淋巴细胞亚群水平对评估患者的细胞免疫功能及疾病的诊断、预后有积极的临床意义。     

恙虫病患者外周血T淋巴细胞亚群的检测

恙虫病立克次体属于专性细胞内寄生的微生物,其免疫机制是以细胞免疫为主。为探讨恙虫病时患者细胞免疫功能,我们对25例临床确诊为恙虫病的患者,进行了外周血T淋巴细胞亚群检测,同时以20名健康献血员作为对照,现将结果报道如下。     

消化性溃疡患者外周血T淋巴细胞亚群的观察

近年来随着免疫学研究的进展，人们对参与细胞免疫反应的T淋巴细胞研究也逐渐深入。现已发现T淋巴细胞亚群在多种疾病中都有异常改变。我们对胃溃疡、十二指肠球部溃疡患者及正常人外周血T淋巴细胞亚群进行观察，旨在进一步探讨胃溃疡和十二指肠球部溃疡患者外周血T淋巴细胞亚群的变化。1资料和方法1．1对象：胃溃疡（活动期）组18例，男性12例，女性6例，年龄42．7土6．1岁。十二指肠球部溃疡（活动期）组22例，男性17例，女性5例，年龄32．8士9．5岁。以上患者均由胃镜室专人用日本Olympus纤维胃镜检查。采用日本3轮3期6级法。部分病人…     

桂北地区恶性肿瘤患者外周血T淋巴细胞亚群和淋巴细胞亚群的相关性研究

目的探究桂北地区恶性肿瘤患者外周血T淋巴细胞亚群和淋巴细胞亚群的数值及其临床意义。方法选取184例肿瘤患者,分别设有鼻咽癌组94例,乳腺癌组32例,宫颈癌组36例,肺癌组22例,并选取了40例符合性别年龄区间的健康体检人员作为正常对照组,运用流式细胞仪检测肿瘤各组和正常组的T淋巴细胞亚群表面因子CD3~+、CD4~+、CD8~+细胞绝对计数和CD4~+/CD8~+比值,淋巴细胞亚群表面因子相对计数CD3~+%、CD56~+%、CD19~+%,并进行统计学分析,比较肿瘤组和正常组之间的差异。结果肿瘤组患者T淋巴细胞亚群细胞绝对计数CD3~+、CD4~+、CD8~+和正常组对比有显著差异(P=0.000),CD4~+/CD8~+比值,鼻咽癌有显著差异(P=0.000),乳腺癌(P=0.634)、宫颈癌(P=0.409)、肺癌(P=0.629)差异无统计学意义。淋巴细胞亚群相对计数与正常组对比,乳腺癌、肺癌差异无统计学意义,鼻咽癌CD3~+%(P=0.000)、CD56~+%(P=0.001)有显著差异,CD19~+%差异无统计学意义;宫颈癌CD3~+%(P=0.000)有显著差异,CD56~+%(P=0.094)差异无统计学意义,CD19~+%(P=0.235)差异无统计学意义。结论恶性肿瘤患者免疫功能异常,通过流式细胞仪检测T淋巴细胞亚群、淋巴细胞亚群项目,对患者病情评估、身体免疫情况实时监测、后期治疗指导用药具有一定的临床应用价值。     

外周血T淋巴细胞亚群测定在卵巢癌患者中的应用

采用流式细胞术测定89例卵巢癌患者及25例健康正常人的外周T血淋巴细胞亚群(CD3+、CD4+、CD8+、CD4+/CD8+),并作比较分析。结果卵巢癌患者CD3+细胞、CD4+淋巴细胞CD4+/CD8+比值显著降低,而CD8+淋巴细胞显著升高,差异均有统计学意义(P0.05)。Ⅰ~Ⅳ期卵巢癌患者,随着期别越高,其外周血中CD4+、CD4/CD8比值逐渐下降,CD8+细胞水平逐渐升高,其中,Ⅰ期与Ⅱ期之间相比,差异无统计学意义(P0.05)。但Ⅲ、Ⅳ与Ⅰ、Ⅱ期之间,Ⅲ期与Ⅳ期之间比较差异均有统计学意义(P0.05),且各组与对照组比较有显著差异(P0.05),年龄对患者外周血T淋巴细胞亚群的影响无显著性(P0.05)。外周血T淋巴细胞亚群可作为卵巢癌患者免疫状态的有效评价指标,定期检测外周血中上述指标的变化,有利于了解恶性肿瘤患者的病情变化及预后。也为肿瘤的免疫增强治疗提供了理论依据。     

Evolution of an Emergency Department Screening Questionnaire for Severe Acute Respiratory Syndrome

OBJECTIVES: To describe the screening tool that was used to screen for severe acute respiratory syndrome (SARS), the three revisions that were made, and the factors that led to these revisions. On March 13, 2003, on receiving notification of an outbreak of atypical pneumonia, nurses from the study emergency department (ED) started screening patients for the disease that became known as SARS. METHODS: The ED nurses started with a simple screening tool that was incorporated into triage. The screening tool was later revised into a questionnaire. An outdoor screening station was set up and patients were subsequently screened before triage. After the patients were screened, they were assigned to different risk areas, where triage and treatment were rendered. Two further revisions were made to the questionnaire. RESULTS: From March 13 to May 31, 11457 patients were screened. Version One of the screening questionnaire was used to screen 72 patients from March 13 to 17, Version Two screened 93 patients from March 18 to 21, Version Three screened 2909 patients from March 22 to April 8, and Version Four screened 8383 patients from April 9 to May 31. There was a significant (p < 0.05) downward trend in the proportion of admissions. Among those discharged from the ED, 0.28% reattended and were later confirmed to have SARS. CONCLUSIONS: The screening tool underwent three major revisions in response to new information. By keeping it relatively simple, user-friendly, and regularly updated, nurses were able to screen patients rapidly. Risk categorization ensured that no cross-infection occurred among patients and that no one contracted SARS in the ED.     

手足口病患儿外周血T淋巴细胞亚群及免疫球蛋白检测的意义

目的检测手足口病患儿外周血T淋巴细胞亚群及免疫球蛋白水平,探讨其细胞及体液免疫状况。方法采用散射比浊法和流式细胞术检测50例手足口病患儿及30例健康儿童的血清免疫球蛋白IgG、IgA、IgM和T淋巴细胞亚群。结果手足口病组T淋巴细胞亚群中CD3+、CD4+及CD8+细胞表达水平明显低于健康对照组,差异有统计学意义(P<0.05);IgG、IgA水平明显低于健康对照组,差异有统计学意义(P<0.05);IgM与健康对照组比较,差异无统计学意义(P>0.05)。结论手足口病患儿存在细胞及体液免疫功能紊乱,为临床手足口病患儿的免疫治疗提供了理论依据。     

中西医结合治疗严重急性呼吸综合征的临床研究思路与方法

本文介绍了联合攻关项目"中西医结合治疗SARS的临床研究"的立项背景、研究思路、研究内容与方法,展示了中西医结合治疗SARS的最新研究成果,同时剖析了SARS临床研究的难点,提出了进一步深化研究的设想.指出遵循循证医学原则,采用多中心、前瞻性、随机对照的研究方案和国际通用的数理统计分析方法,是科学、客观地评价中西医结合治疗SARS有效性和安全性的必由之路.     

新生儿高胆红素血症诊治中T淋巴细胞和白介素-6变化的研究

目的探讨新生儿高胆红素血症诊治过程中患儿体内胆红素、T淋巴细胞亚群以及白介素-6（IL-6）水平的变化及其临床意义。 方法选择2015年1~12月内蒙古医科大学第三附属医院住院的40例高胆红素新生儿作为高胆组,再根据对高胆红素新生儿采取的治疗方法不同,分为高胆1组20例（常规蓝光治疗）和高胆2组（常规蓝光治疗加妈咪爱）;选取同期与高胆组日龄相匹配的20例健康足月新生儿（无黄疸或血清胆红素水平≤205.2 μmol/L）作为对照组。采用方差分析比较各组血清胆红素、T淋巴细胞亚群、IL-6水平的差异,并进行组间的两两比较,采用Pearson相关性分析分析高胆1、2组胆红素与IL-6及CD4^＋/CD8^＋比值的相关性。 结果治疗前,高胆1组及高胆2组新生儿T淋巴细胞亚群与对照组比较：CD3^＋［（48.00±5.28）% vs （46.60±5.57）% vs （60.54±4.66）%］、CD4^＋［（31.05±5.09）% vs （33.50±4.80）% vs （44.86±3.75）%］及CD4^＋/CD8^＋比值（0.93±0.21 vs 0.95±0.23 vs 1.32±0.17）均较对照组降低,差异具有统计学意义（P<0.001）;而高胆1组与高胆2组新生儿的IL-6值与对照组比较均升高［（21.73±2.35）ng/ml vs （22.05±2.58）ng/ml vs （10.85±2.11）ng/ml］,差异具有统计学意义（P<0.001）;治疗后,高胆1、2组患儿CD3^＋［（46.15±7.17）% vs （55.15±6.89）% vs （60.54 ±4.66）%］、CD4^＋［（29.45±5.64）% vs （37.85±5.49）% vs （44.86 ±3.75）%］、CD4^＋/CD8^＋比值（0.92±0.22 vs 1.12±0.25 vs 1.32±0.17）,较对照组比较仍较低,IL-6水平与对照组比较仍偏高［（23.83±3.34）ng/ml vs （14.91±2.31）ng/ml vs （10.85±2.11）ng/ml］,差异具有统计学意义（P<0.01）;但高胆2组与高胆1组CD3^＋、CD4^＋、CD4^＋/CD8^＋比较却明显升高,IL-6水平也下降明显,差异具有统计学意义（P<0.01）。治疗前总体的血清胆红素水平与高胆1、2组CD4^＋/CD8^＋比值呈负相关（r=-0.780、-0.594,P<0.01）,而与IL-6水平呈正相关（r=0.752、0.591,P<0.01）。 结论新生儿高胆红素血症时患儿体内存在细胞免疫功能紊乱及细胞因子分泌紊乱情况,光疗在降低高间接胆红素的同时对新生儿的免疫功能改善不明显,口服免疫调节剂妈咪爱可有效弥补光疗的不足。     

Collection of peripheral blood mononuclear cells as a byproduct of plateletpheresis with two different blood cell separators

Peripheral blood mononuclear cells (PBMC) were collected as a byproduct of plateletpheresis of normal blood cell donors using modifications to standard automated protocols on either the CS-3000 or Spectra blood cell separator machine. Comparison of the PBMC products obtained showed X ± SD WBC yields of 5.3 ± 3.4 vs. 3.8 ± 2.0 × 10⁹ with the CS-3000 and Spectra, respectively (P < .0001). The majority of the cells were lymphocytes, with 13–15% monocytes with both machines. Sixteen percent of the WBC collected with the Spectra, but only 1% of those collected with the CS-3000, were granulocytes. The CS-3000 PBMC product contained fewer RBC (0.2 ± 0.1 × 10¹¹ vs. 2.4 ± 0.6 × 10¹¹) and more platelets (1.6 ± 0.6 × 10¹¹ vs. 0.35 ± 0.39 × 10¹¹) in a smaller volume (40 ± 14 ml vs. 229 ± 37 ml) than the Spectra products. Comparison of the platelet collections harvested when PBMC were also collected to platelets harvested using standard procedures on the same machine showed no change in platelet. WBC, or RBC yields for the Spectra. A significant increase in mean WBC contamination from 40 ± 56 × 10⁷ to 112 ± 205 × 10⁷ and a small, but statistically insignificant, decrease in platelet yield from 4.1 ± 1.2 × 10¹¹ to 3.9 ± 1.8 × 10¹¹ was observed in the CS-3000 platelet collections when PBMC were harvested. There was no sustained change in donor lymphocyte counts and no change in acute donor side effects or time requirements when PBMC were collected. The procedural modifications were easily learned by multiple operators, and required about 15 and 5 min additional operator time on the CS-3000 and Spectra, respectively. Thus, harvest of large numbers of PBMC as a byproduct of plateletpheresis can be readily accomplished with either of 2 different blood cell separator machines. The cells obtained have been useful for a variety of purposes in both clinical hospital and basic research laboratories. © 1992 Wiley-Liss, Inc.     

过敏性紫癜患儿急性期细胞免疫功能变化及临床意义

目的：探讨过敏性紫癜（HSP）患儿急性期外周血淋巴细胞免疫功能变化及其临床意义。方法采用流式细胞术法分别测定32例HSP患儿急性期外周血T细胞亚群CD3＋T细胞、CD4＋T细胞、CD8＋T细胞、CD4＋/CD8＋的水平,并与20名健康儿童比较分析。结果HSP患儿急性期外周血T细胞亚群CD4＋T细胞和CD4＋/CD8＋均降低,而CD8＋T细胞水平增高,与对照组比较差异有统计学意义（P＜0.05）;CD3＋T细胞差异无统计学意义（P＞0.05）。结论 HSP急性期存在细胞免疫功能紊乱,并且其可能为HSP的发病机制。     

经急诊诊断13例非典型肺炎病人的临床特点

目的:探讨经急诊诊断的13例非典型肺炎的临床特点。以进一步提高诊断的符合率。方法:对13例非典型肺炎病人资料进行回顾性统计分析。结果:与非典病人有明确接触史的有7例(53.85％);主要表现:发热11例(84.62％),咳嗽9例(69.23％),气促9例(69.23％);血常规:白细胞(WBC)<4.0×109有4例(30.17％),WBC 4.0×109-10×109有7例(53.83％),WBC>10×109有2例(15.38％);粒细胞百分比(GR)>70％有10例(76.92％),GR 50％-70％有2例(15.38％),GR<50％有1例(7.69％);淋巴细胞百分比(LY)>40％有1例(7.69％),LY 20％-40％有3例(23.08％),LY<20％有9例(69.23％);胸片和CT显示肺斑片状阴影:双侧改变8例(61.54％),单侧改变5例(38.46％)。结论:本组病人多数与非典病人有接触,发热,咳嗽,双肺或单肺斑片状阴影,粒细胞百分比增高,淋巴细胞百分比下降是其主要临床特点,但有个别病人表现不典型,只有认真地询问病史和检诊病人才能避免急诊病人的漏诊和误诊。