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目的 研究SARS患者T淋巴细胞亚群的动态变化规律 ,探索SARS特异性早期诊断的指标 ,寻找SARS的病情发展的预警指标 ,为研究SARS发病机制提供依据。方法 收集我院SARS确诊病人 2 5 2例患者的抗凝血 ,用特异性荧光抗体标记 ,通过FACS流式细胞仪检测CD4,CD3 ,CD8,NK ,CD4/CD8。每 3～ 5d复查 1次 ;比较不同病情及病程不同阶段时 ,上述指标的变化及相关关系。结果 所有的SARS患者在病程的第 1,2周 ,均有CD4,CD3 ,CD8,下降 ,在第 2周时降至最低 ,尤其以CD4下降最明显 ,在第 3周开始回升。重型患者CD4,CD3 ,CD8的变化规律与轻型相同 ,但下降程度更严重 ,持续时间更长。CD4+ 淋巴细胞计数在轻型患者病程第一周为 5 15± 44 4/μl ,第二周 42 1± 3 5 0 /μl ,第 3周为 60 0± 3 89/μl ,各周间差异均有显著性 ( P <0 0 5 ) ,第 4周为 773± 45 6/μl ,恢复至正常水平。在重型患者的病程第一周为 3 12± 15 8/μl,第二周 2 5 5± 187/μl,( P >0 0 5 ) ,在第三周回升为 43 5± 3 43 /μl ,第 4周5 3 9± 3 94/μl,仍未恢复至正常。NK细胞在发病期间亦有所下降 ,但其水平波动不大。CD4/CD8在整个发病过程中变化不大 ,基本在正常水平。结论 CD4,CD3 ,CD8等淋巴细胞亚群减少是早期诊断的敏感指标 ,也是病情加?
Objective To study the dynamic changes of T lymphocyte subsets in patients with SARS and to explore the indexes of SARS specific early diagnosis and find the early warning indexes of SARS in order to provide basis for studying the pathogenesis of SARS. Methods Anticoagulant blood was collected from 252 SARS patients in our hospital and labeled with specific fluorescent antibody. CD4, CD3, CD8, NK and CD4 / CD8 were detected by FACS. Every 3 ~ 5d review 1 times; different stages and different stages of disease, the above indicators of change and the relationship between. Results All patients with SARS had CD4, CD3 and CD8 decreased in the first and second weeks of their course of disease, and they all dropped to the lowest in the second week. In particular, CD4 decreased most obviously and began to rise in the third week. The changes of CD4, CD3 and CD8 in severe patients were the same as those in light, but the degree of decline was more serious and lasted longer. CD4 + lymphocyte count in the first week of mild disease in patients with 5 15 ± 44 4 / μl, the second 42 1 ± 350 / μl, the third week of 60 0 ± 3 89 / μl, the difference was Significance (P <0 05), 4 weeks 773 ± 45 6 / μ l, returned to normal levels. During the first week of heavy-duty patients, the course was 3 12 ± 15 8 / μl, the second week 25 5 ± 187 / μl, (P 0 05), the third week 43 43 ± 3 43 / μl, Week 4 5 3 9 ± 3 94 / μl, has not returned to normal. NK cells also decreased during the onset, but their levels did not fluctuate significantly. CD4 / CD8 in the course of the disease did not change much, basically at normal levels. Conclusion The decrease of CD4, CD3, CD8 and other lymphocyte subsets is a sensitive indicator of early diagnosis, but also the condition plus?