Ⅰ型出血热患者中性粒细胞与淋巴细胞功能变化研究

目的研究肾综合征出血热（ＨＦＲＳ）患者的淋巴细胞和中性粒细胞免疫功能变化及其相互间关系，进一步阐明发病机理。方法采用Ｅａ、Ｅｔ花环形成、ＰＨＡ皮肤试验及中性粒细胞趋化、吞噬、ＮＢＴ还原等多种试验方法同时对３２例由Ｈａｎｔａａｎ病毒引起的姬鼠型ＨＦＲＳ患者的淋巴细胞和中性粒细胞免疫功能变化及其相互间关系进行动态测定。结果ＨＦＲＳ患者早期前五项指标均明显低于正常人（Ｐ＜０．０１）；病程中，淋巴细胞损伤程度较粒细胞更加突出；中性粒细胞ＮＢＴ还原能力在恢复期反降至最低（Ｐ＜０．０５）。此外，患者这两种细胞的免疫功能在恢复期并未能完全达到正常水平。结论ＨＦＲＳ患者淋巴细胞免疫功能损伤程度与病程密切相关，可能是Ｈａｎｔａａｎ病毒直接作用的结果；而中性粒细胞免疫功能变化比较复杂，有待进一步研究。恢复期患者细胞免疫功能未能完全恢复提示临床治疗应予以关注。

Research on functions of polymorphonuclear neutrophil and lymphocyte in HFRS patients infected with Hantaan virus

Objective To clarify the pathogenesis of the hemorrhagic fever with renal syndrome (HFRS), the investigations on the immune functions of polymorphonuclear neutrophil and lymphocyte in HFRS were made. Methods The total and the activated erythrocyte rosette forming cell counts, phytohemagglutinin skin test, chemotactic and phagocytic activities as well as the nitroblue tetrazolium (NBT) dye reduction were respectively performed on 32 HFRS patients infected with Hantaan virus. A dynamic observation on the function change of the patients' polymorphonuclear neutrophil and lymphocyte was done simultaneously. The statistical table and chart were given for the test results. The dynamic changes of polymorphonuclear neutrophil and lymphocyte's functions were showed schematically. Results The results showed that all these functional indices except for NBT of HFRS patients decreased sharply ( P <0.01) in febrile and oliguria phases compared with those of the normal group. Relatively, the activities of lymphocyte in HFRS patients were even more severely depressed. The reduction of nitroblue tetrazolium dye of polymorphonuclear neutrophil , however, was found to be lowest ( P <0.05) in the convalescence phase. Also in this phase, most of immune functions tested in present research were not perfectly recovered. Conclusions The functional changes of lymphocyte in HFRS are closely related with the patients' different phases (febrile, oliguria, diuria and convalescence). It is probable the direct role of Hantaan virus infection. Further more investigations are required to clarify the immune functions of polymorphonuclear neutrophil in HFRS because of its complicate responses. Attentions in clinic should be paid to the patients in convalescence phase.