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目的 观察SAR5患者T淋巴细胞亚群绝对数量的变化与肺内病变情况(病变程度及肺内炎症吸收程度)。方法 用流式细胞仪MultiTEST方法对82例发病14d内的SARS患者外周血标本进行T淋巴细胞亚群绝对数量的动态监测,同时动态观察其与肺内病变程度及炎性病变吸收程度的关系,并分析糖皮质激素对T细胞亚群的影响。结果 ①51例病情较轻患者的外周血T细胞亚群在正常范围内或轻度异常,临床上不需要糖皮质激素治疗;②31例病情呈进展状态的患者均伴有CD4~+细胞减少及肺内病变重,需糖皮质激素治疗。82例患者外周血CD4~+细胞绝对数量与病变程度的相关性为r=-0.684,P=0.000;③31例经糖皮质激素治疗的患者CD4~+细胞及CD8~+细胞绝对计数明显少于糖皮质激素治疗前(P=0.000);④CD8~+细胞数量及与肺内病变吸收程度密切相关(r=-0.816;P=0.000)。结论 ①SARS患者肺内病变程度与CD4~+细胞数量呈负相关;②糖皮质激素治疗后SARS患者外周血CD4~+细胞及CD8~+细胞绝对计数减少;③SARS患者肺内病变的吸收程度与CD8~+细胞数量有良好的负相关性。
Objective To observe the changes of the absolute number of T lymphocyte subsets in SAR5 patients and the pathological changes in the lungs (the degree of lesion and the degree of absorption of intrapulmonary inflammation). Methods Flow cytometry MultiTEST method was used to detect the absolute number of T lymphocyte subsets in 82 peripheral blood samples of patients with SARS within 14 days of onset and dynamically observe the relationship with the extent of intrapulmonary lesions and the degree of inflammatory lesions absorption, And analyze the impact of glucocorticoids on T cell subsets. Results ① The peripheral blood T lymphocyte subsets in 51 patients with mild disease were in the normal range or mildly abnormal and did not require glucocorticoid therapy clinically.23 patients with advanced disease were accompanied by decreased CD4 ~ + cells and lung Heavy lesions within the need for glucocorticoid treatment. The absolute number of CD4 ~ + cells in peripheral blood of 82 patients was r = -0.684, P = 0.000; ③ The absolute counts of CD4 ~ + cells and CD8 ~ + cells in 31 patients treated with glucocorticoid were significantly less than Glucocorticoid treatment before (P = 0.000); ④CCD8 ~ + cell number and lung lesions closely related to the degree of absorption (r = -0.816; P = 0.000). CONCLUSIONS ① The degree of intra-lung lesion in SARS patients is negatively correlated with the number of CD4 ~ + cells. ② The absolute counts of CD4 ~ + cells and CD8 ~ + cells in peripheral blood of patients with SARS are decreased after glucocorticoid therapy. ~ + Cell number has a good negative correlation.