95例SARS患者T细胞及其亚群动态变化的观察

对 95例SARS患者的T淋巴细胞亚群动态变化进行分析。其中 85例痊愈 ,1 0例死亡。 85例痊愈患者 ,病程第 7天平均CD4 + ( 3 2 5± 1 90 )个 /μL ,CD8+ ( 3 1 9± 3 1 5 )个 /μL ,CD4 + /CD8+ 1 .2 5± 0 .71 ,与我国正常人相比〔平均CD4 + ( 72 7± 2 5 5 )个 /μL、CD8+ ( 5 3 9± 1 3 4)个 /μL ,CD4 + /CD8+ 1 .49〕 ,T淋巴细胞亚群明显下降 (P =0 .0 0 1 )。病程第1 4天左右免疫功能逐渐恢复 ,平均CD4 + ( 5 61± 5 2 2 )个 /μL ,CD8+ ( 3 70± 2 71 )个 /μL ,CD4 + /CD8+ 1 .68± 1 .1 1。 2 1d后免疫功能基本恢复正常 ,平均CD4 + ( 675± 448)个 /μL ,CD8+ ( 4 67± 2 41 )个 /μL ,CD4 + /CD8+ 1 .48± 0 .68。 1 0例死亡患者的T细胞亚群在入院后逐渐出现下降趋势 ,病程第 7天CD4 + ( 2 48± 82 )个 /μL ,CD8+ ( 2 3 3± 1 1 5 )个 /μL ,CD4 + /CD8+ 1 .2 1± 0 .40 ,第 1 4天T淋巴细胞继续下降 ,平均CD4 + ( 1 81± 1 2 8)个 /μL ,CD8+ ( 1 73± 1 0 9)个 /μL ,CD4 + /CD8+ 1 .1 7± 0 .45 ,2 1d后CD4 + 细胞继续下降 ,平均CD4 + ( 1 2 5± 46)个 /μL ,CD8+ ( 94± 3 8)个 /μL ,CD4 + /CD8+ 1 .44±0 .5 9。结果提示 :SARS患者早期可能存在异常的免疫反应 ,这种异常免疫反应可能是导?

Dynamic Analysis of T Lymphocyte and Subset in 95 SARS Patients

The aim was to analyze the dynamic variation of T lymphocyte subset in 95 patients with severe acute respiratory syndrome (SARS).Among all 95 patients, 85 patients were survivor, 10 patients died of this severe disease.As for 85 survivor patients, the average CD⁴⁺T lymphocyte count and CD⁸⁺ T lymphocyte count were (325±190)cells/μL and (319±315)cells/μL, in 7th day of disease course, respectively, the ratio of CD⁴⁺T/CD⁸⁺ T was 1.25±0.71 which were distinctly lower than that of the normal Chinese peoples whose average CD⁴⁺T lymphocyte count were (727±255)cells/μL, CD⁸⁺ T (539±134)cells/μL, CD⁴⁺T/CD⁸⁺ T were 1.49(P= 0.001).14 days later of disease course, the immunological function of the SARS patients recovered gradually, the average CD⁴⁺T were (561±522)cells/μL, CD⁸⁺ T (370±271)cells/μL, CD⁴⁺T/CD⁸⁺ T were 1.68±1.11.21 days later, their immunological function became normal, the average number of CD⁴⁺T lymphocyte count were (675±448)cells/μL, CD⁸⁺ T lymphocyte count were (467±241)cells/μL, CD⁴⁺T/CD⁸⁺ T 1.48±0.68.While T lymphocyte subset of 10 dead cases appeared to decline in 7th day, 14th day and 21th day.first, their CD⁴⁺T lymphocyte count went down from (248±82)cells/μL in 7th day to (181±128)cells/μL in 14th day and (125±46)cells/μL in final.CD⁸⁺ T lymphocyte count from (233±115)cells/μL to (173±109)cells/μL and to (94±38)cells/μL in final.CD⁴⁺T/CD⁸⁺ T was 1.21±0.40, 1.17±0.45, 1.44±0.59.Conclusion: Activation of abnormal immune response were common in the early stage of SARS, it may be closely correlated to rapidly progression of this disease.T lymphocyte subset will recovery in the second week of disease course, However, it will have bad prognosis if T lymphocyte subset continues to go down without recovery.