肾综合征出血热患者不同临床阶段炎性指标的变化

 目的 探讨肾综合征出血热(hemorrhagic fever of renal syndrome,HFRS)病程中PCT、CRP变化规律及其T淋巴细胞亚群变化。方法 搜集2011-01至2014-12北京地坛医院及合作医院丹东传染病医院收治的HFRS病例,对流行病学史、PCT、CRP及T淋巴细胞亚群指标进行统计分析。结果 91例HFRS患者入组,早期PCT、CRP即显著升高,多尿期、恢复期逐渐下降,病情越重,PCT、CRP越高。发病早期、中期、晚期PCT差异有统计学意义(P<0.001)。轻型-重型、轻型-危重型、中型-危重型患者PCT组间差异均有统计学意义(P<0.05)。发病早期、中期、晚期CRP组间差异有统计学意义(P<0.001)。除重型-危重型外,余组间CRP差异均具有统计学意义(P<0.05)。HFRS发病早期CD4⁺T淋巴细胞绝对值下降,CD8⁺T淋巴细胞绝对值升高,CD4⁺T淋巴细胞/CD8⁺T淋巴细胞比值下降。结论 早期监测PCT、CRP可能有助于判断HFRS病情严重程度,HFRS患者存在T细胞亚群比例失衡,可能对病情判断及预后提供帮助。

Inflammatory markers in patients with hemorrhagic fever of renal syndrome

Objective To analyze the regularity of dynamic changes of such inflammatory indexes as PCT and CRP and the changes of T-lymphocyte subsets in patients with hemorrhagic fever of renal syndrome(HFRS).Methods Data on the history of epidemiology, levels of PCT, CRP and T-lymphocyte subsets of patients with HFRS treated between 2011 and 2014 was collected for statistical analysis.Results Ninety-one patients with HFRS were included in this study. PCT and CRP levels increased significantly in the early stage, gradually declined in the polyuria phase and recovery phase. The more severe the disease was, the higher the levels of PCT and CRP were. During the early, middle and late stages, the difference in PCT was statistically significant (P<0.001). The difference in PCT between different groups of patients was also statistically significant (P<0.05). The difference of CRP was statistically significant between the three stages(P<0.001). With the exception of the severe type and critically severe group, the difference of CRP between the other groups was statistically significant (P<0.05). In the early stage of HFRS, the number of CD4⁺T lymphocytes was decreased while the number of CD8⁺T cells was increased, and the CD4/CD8 ratio was reduced.Conclusions Early detection of PCT and CRP may help to assess the severity of disease. The possible ratio imbalance in T-lymphocyte subsets in patients with hemorrhagic fever of renal syndrome may provide useful information for clinicians in the assessment and prognosis of disease.