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目的 研究外周血T淋巴细胞核仁区嗜银蛋白 (AgNORs)染色对严重急性呼吸综合征(SARS)的诊断意义。 方法 PHA刺激外周血T淋巴细胞培养 ,KL型肿瘤免疫图像分析系统分析AgNORs区面积与细胞核仁区的百分比 (I.S %) ,同时观察培养后的细胞形态变化。 结果 I .S %在 8例正常健康对照组为 7.38± 0 .75 ,8例非SARS肺炎组为 8.98± 0 .91,4例SARS(均为地方患者 )组为 1.6 7± 1.13。SARS患者细胞培养后其体积较正常对照组或非SARS组小 ,很少见到被银染的颗粒 ,提示SARS患者的T淋巴细胞对PHA刺激几乎无反应 ,尤其是病情危重的病人更显著。 结论 AgNORs降低对SARS有一定的临床诊断意义 ,也可以作为病情加重的指标 ,细胞形态变化更加明显。
Objective To study the diagnostic value of AgNORs in peripheral blood T lymphocytes in the diagnosis of severe acute respiratory syndrome (SARS). Methods The peripheral blood T lymphocytes were stimulated by PHA. The percentage of AgNORs area and nucleolar area (I.S%) was analyzed by KL immunohistochemical method. The morphological changes of the cells were observed. Results The percent of I was 7.38 ± 0.75 in 8 patients with normal controls, 8.98 ± 0.91 in 8 patients with non-SARS pneumonia and 1.6 ± 1.13 in 4 patients with SARS (all patients with local disease). SARS patients were smaller than the normal control group or non-SARS group after culturing. SARS patients seldom found silver-stained particles, suggesting that T lymphocytes in SARS patients have almost no response to PHA stimulation, especially in critically ill patients. Conclusions The reduction of AgNORs has certain clinical significance for SARS diagnosis, and can also be used as an indicator of aggravation of SARS. The morphological changes of cells are more obvious.