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目的 :观察SARS患者在疾病早期CD4 + 细胞的改变及其在疾病的发展及治疗选择中的临床意义。方法 :流式细胞仪方法对 5 2例发病 10天内确诊为SARS患者的外周血标本进行T细胞亚群的绝对计数检测并动态观察胸部X光病变的变化及疾病转归。结果 :在 5 2例患者中 ,有 34例CD4 + 细胞绝对数在正常范围内的患者 ,病变范围小、病情呈稳定状态 ,病变吸收快 ,不需要肾上腺糖皮质激素治疗 ;另有 18例患者出现CD4 + 细胞的绝对值低于正常 ,其中有 13例患者病情呈进展状态 ,加用肾上腺糖皮质激素治疗 ,有 5例CD4 + 细胞绝对数轻度减低患者 ,病情处于稳定状态 ,未加用肾上腺糖皮质激素治疗。两组CD4 + 细胞数经统计学分析P =0 0 0 0 ;CD4 + 细胞数与肺内病变程度的Pearson相关性检验结果为r =- 0 737;P =0 0 0 0 ;与糖皮质激素应用的Pearson相关性检验结果为r =- 0 5 73;P =0 0 0 0。结论 :①SARS患者发病早期外周血CD4 + 细胞绝对计数与肺内病变的程度呈良好的负相关 ;②CD4 + 细胞绝对数下降明显者需糖皮质激素治疗。
Objective: To observe the changes of CD4 + cells in SARS patients early in the disease and its clinical significance in disease development and treatment options. Methods: Flow cytometry was used to detect the absolute count of T lymphocyte subsets in peripheral blood samples of 52 patients diagnosed as SARS within 10 days and to observe the changes of chest X-ray and the outcome of the disease. Results: Among the 52 patients, 34 patients with absolute CD4 + cells in the normal range had a small lesion, stable disease, rapid absorption of the disease and no adrenal glucocorticoid therapy. In addition, 18 patients The absolute value of CD4 + cells was lower than normal, of which 13 patients were in a state of progress, plus glucocorticoid therapy, 5 cases of absolute CD4 + cells slightly reduced in patients with stable condition, no use Adrenal glucocorticoid treatment. The number of CD4 + cells in the two groups was statistically analyzed P = 0 0 0 0; Pearson correlation test between the number of CD4 + cells and the degree of intrapulmonary lesions was r = - 0 737; P = 0 0 0 0; and glucocorticoid The Pearson correlation test applied was r = - 0 5 73; P = 0 0 0 0. Conclusion: (1) The absolute counts of CD4 + cells in peripheral blood of patients with SARS are negatively correlated with the degree of lung lesions in the early onset of SARS; (2) Glucocorticoid treatment is required for those patients whose absolute number of CD4 + cells declines obviously.