SARS患者T淋巴细胞亚群的改变及动态观察

目的　了解SARS患者T细胞亚群的改变及动态变化 ,探讨其发病机理及对预后的影响。方法　将住院 5 4例SARS患者分为治愈组 (31例 )与死亡组 (2 3例 )两组 ,用流式细胞仪进行T细胞亚群的动态观察。结果　治愈组与死亡组CD4 + 、CD8+ 均值在发病初的 15d内均显著低于正常值 ,死亡组更为显著 ,但两组比较P >0 .0 5 ,差异无显著性。发病 15d后治愈组CD4 + 、CD8+ 均值显著上升 ,而死亡组CD4 + 、CD8+ 均值持续低水平 ,两组比较P <0 .0 0 1,差异有非常显著性。治愈组早期 (≤15d)与后期 (>15d)CD4 + 、CD8+ 均值比较P <0 .0 0 1,差异有非常显著性。死亡组早期与后期CD4 + 、CD8+ 均值比较P >0 .0 5 ,差异无显著性。结论　SARS患者在发病初的 15d内细胞免疫功能是低下的。治愈组 15d后细胞免疫功能逐渐恢复正常 ,预后良好。而死亡组 15d后细胞免疫功能持续低水平 ,提示预后不良。发病的第 15天左右是疾病的转折点。CD4 + 值持续 <2 5 0 ,CD8+ 值持续 <2 0 0是预后不良的重要指标。

Subsets of peripheral T lymphocyte in SARS patients

Objective To investigate the change of subsets of peripheral T lymphocyte in patients with severe acute respiratory syndrome (SARS) and their clinical significance. Methods Subsets of peripheral T lymphocyte from 54 patients with SARS (included 23 dead cases) were examined by flow cytometer. Results The numbers of both CD4 + and CD8 + lymphocytes were significantly decreased in acute phase (15 days) of SARS patients. No significant difference was found between dead and alive groups ( P >0.05). After 15 days of treatment the numbers of CD4 + and CD8 + lymphocytes of the alive cases were significantly increased and the in dead cases the numbers were still lower ( P <0.001). Conclusion The patients with SARS were found to have a damaged cellular immunity. The alive patients would recovered from the damage of cellular immunity after 15 days. The a poor prognosis would be expected if the number of CD4 + was persistantly lower then 250.