240例SARS患者T淋巴细胞及活化亚群的变化

目的研究严重急性呼吸综合征(severeacuterespiratorysyndrome,SARS)患者外周血T淋巴细胞及其活化亚群的变化情况。方法采用多色荧光标记流式细胞术结合血液分析仪,检测240例不同病程的SARS患者(包括50例重型患者和190例普通型患者)的外周血T淋巴细胞及其活化亚群的表达情况。结果在年龄、性别无显著差异时,与正常对照组比较,SARS患者的外周血T淋巴细胞及其各活化亚群绝对值明显减低,其中CD3+CD25+、CD3+HLA-DR亚群百分比升高;与普通型患者比较,重型患者T细胞、CD4+亚群的绝对值均明显减低,CD25+CD3+、CD28+CD4+及CD95+CD4+亚群的绝对值也明显降低;各病程SARS患者比较,T淋巴细胞(包括CD4、CD8亚群)的绝对值为Ⅲ组>Ⅱ组>Ⅰ组;CD25+CD3+、CD28+CD4+及CD95+CD4+亚群的绝对值也明显降低。结论伴随着全面低下的细胞免疫功能,SARS患者的T细胞有效活化过程有所改变,以重型SARS患者尤其明显。

Change of T lymphocyte and its activated subsets in SARS patients

OBJECTIVE: To study abnormal changes of T lymphocyte and its activated subsets in severe acute respiratory syndrome (SARS) patients. METHODS: Flow cytometer with multi-color flouroscence and hematology analyzer were used to detect the expression of T lymphocyte and its activated a subsets in 240 SARS patients including 50 cases of critical type and 190 cases of common type. RESULTS: Statistical analysis by means of SAS software showed that there was significant decrease in absolute counts (AC) of T lymphocyte and its subsets in SARS patients when compared with normal people, while percentages (PC) of CD3+CD25+ and CD3+ HLA-DR+ subsets were increased markedly. Compared with common type, there was significant decrease in absolute counts of critical type of T lymphocyte, CD4+, CD25+CD3+, CD28+CD4+, and CD95+CD4+subsets. The ACs of T lymphocytes including CD4 and CD8 subsets in different phases were as below: III > II > I. The ACs of subsets involved in activation such as CD3+ HLA-DR+/lym, CD3+CD25+/lym, CD28+CD4+/CD4, CD28+CD8+/CD8, and CD38+CD4+/CD4 all were highest in group III. In addition, the AC and PC of CD95+CD4+/CD4 and CD95+CD8/CD8 subset in group III were highest while group I was lowest. CONCLUSIONS: With depressing cellular immunity, the activation of T lymphocytes were suppressed obviously in SARS patients, especially for critical patients.