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目的 了解SARS患者T细胞亚群的改变及动态变化 ,探讨其发病机理及对预后的影响。方法 将住院 5 4例SARS患者分为治愈组 (31例 )与死亡组 (2 3例 )两组 ,用流式细胞仪进行T细胞亚群的动态观察。结果 治愈组与死亡组CD4 + 、CD8+ 均值在发病初的 15d内均显著低于正常值 ,死亡组更为显著 ,但两组比较P >0 .0 5 ,差异无显著性。发病 15d后治愈组CD4 + 、CD8+ 均值显著上升 ,而死亡组CD4 + 、CD8+ 均值持续低水平 ,两组比较P <0 .0 0 1,差异有非常显著性。治愈组早期 (≤15d)与后期 (>15d)CD4 + 、CD8+ 均值比较P <0 .0 0 1,差异有非常显著性。死亡组早期与后期CD4 + 、CD8+ 均值比较P >0 .0 5 ,差异无显著性。结论 SARS患者在发病初的 15d内细胞免疫功能是低下的。治愈组 15d后细胞免疫功能逐渐恢复正常 ,预后良好。而死亡组 15d后细胞免疫功能持续低水平 ,提示预后不良。发病的第 15天左右是疾病的转折点。CD4 + 值持续 <2 5 0 ,CD8+ 值持续 <2 0 0是预后不良的重要指标。
Objective To understand the changes and dynamic changes of T cell subsets in patients with SARS and to explore its pathogenesis and prognosis. Methods Fifty-four inpatients with SARS were divided into two groups: the cured group (31 cases) and the dead group (23 cases). The dynamic changes of T cell subsets were analyzed by flow cytometry. Results The mean of CD4 + and CD8 + in the cured group and the dead group were significantly lower than the normal value within 15 days of onset, and the death group was more significant. However, there was no significant difference between the two groups (P> 0.05). The mean of CD4 + and CD8 + in the cured group increased significantly after 15 days of onset, while the mean of CD4 + and CD8 + in the dead group continued to be low. The difference between the two groups was significant (P <0.01). The difference of CD4 + and CD8 + between the early treatment group (≤15d) and the later (> 15d) P <0.01, the difference was significant. The death group early and late CD4 +, CD8 + mean comparison P> 0.05, the difference was not significant. Conclusion The cellular immune function of patients with SARS is low within 15 days after onset. After 15 days, the cellular immune function of the cured group gradually returned to normal with a good prognosis. The death group 15d after the continued low level of cellular immune function, suggesting a poor prognosis. The onset of the first 15 days or so is a turning point in the disease. The CD4 + value of <250, CD8 + value of <200 is an important indicator of poor prognosis.