SARS预后2年T淋巴细胞亚群水平及影响因素的研究  

作　　者：罗宏[1] 宋承平 阎建栋 郭志宏[2] 

机构地区：[1]太原市第四人民医院,山西030053 [2]太原市中心医院

出　　处：《中华临床医学杂志》2007年第5期1-5,共5页Chinese Journal of Clinical Practical Medicine

摘　　要：目的研究SARS患者预后2年T淋巴细胞亚群的变化，探讨其变化的影响因素及发生机制。方法于2005年5月对100例预后2年的SARS确诊病例和29例健康献血者作为对照组进行随访调查，收集流行病学基线资料和体检资料，同时抽取5ml抗凝肘静脉血，采用流式细胞仪检测其外周血CD3^＋、CD4^＋及CD8^＋T淋巴细胞百分比；采用全自动血细胞分析仪检测其外周血白细胞计数及分类。结果（1）100例SARS确诊病例CD4／CD8〈1.5者70例，〉1.5者有30例；病例组CD3^＋CD4^＋细胞率（30.29±7.69）％明显低于对照组（43.15±2.99）％，（t=6.12，P〈0.01）；病例组CD3^＋CD8^＋细胞率（69.51）明显高于对照组（49．45），（Z=-2．54，P〈0.05）；病例组CD3^＋／CD8^＋（56．43）明显低于对照组（94.55），（Z=-4．84，P〈0.01）；病例组淋巴细胞绝对值（0.83±0.44）明显低于对照组（1.87±0．68），（t=9.71，p〈0.01）；（2）不同性别、年龄、有无吸烟、有无饮酒者的CD4／CD8值没有差别（t值分别为．1．90、．0．09、1.40、0.395，P均〉0．05）；（3）病例组中CD4／CD8值在应用免疫调节剂和未应用免疫调节剂两组间有显著性差异（t=2．81，P〈0．05），应用免疫调节剂组CD4／CD8值明显低于未应用免疫调节剂组；在有无应用糖皮质激素两组间无差异（t=1．097，P〉0．05）；激素应用总量、日平均量、单日最大剂量及应用时间与CD4／CD8值无相关关系，（r分别为-0．21、0．162、0．073、-0．125，P均〉0．05）；（4）发病期间淋巴细胞百分比最低值、淋巴细胞绝对值最低值、SaO2最低值、PaO2最低值，肺部病变范围与CD4／CD8无相关关系，（r值分别为0，129、0．05、0．165、0．179、0．001、P均〉0．05）；（5）CD4／CD8值与骨关节病变的严重程度、肺纤维化发生情况无相关关系（r值分别为．0．078，0．001，P均〉0.05）。结论Objective To study changes of the SARS patients＇ T lymphocyte subgroupprognosis for two years, and to investigate these changes＇ influential factors and developing mechanism.Methods To follow-up investigate 100 SARS cases for prognosis two years in May, 2005 and to use 29 healthy blood donors as control. Then to collect theepidemiology baseline data and health examination data, at the same time, to draw off 5ml anticoagulation blood from ulnar vein, in which detect the ratio of peripheral blood CD3^＋, CD4^＋ and CD8^＋ T lymphocyte by employing flow c-ytometer and detect the peripheral blood leucocyte count and classificationby employing whole-automatic cytoanalyze.Results （1）There are 70 patients on CD4/CD8〈 1.5,30 patients on CD4/CD8 〉1.5 in the 100 final diagnose SARS cases; CD3^＋CD4^＋ in case groups（30.29±7.69）% is lower significantly than the controls （43.15±2.99）%,（t=6.12,P〈0.01）;CD3^＋CD8^＋T lymphocyte rates in cases （69.51） is higher significantly than the controls＇ （49.45）, （Z=-2.54,P〈0.05）; CD3^＋/CD8^＋ T lymphocyte rates in cases（56.43） is lower significantly than the controls（94.55）,（z=-4.84,P〈0.01）; The lymphocyte＇s absolute value in cases（0.83 ± 0.44） is lower significantly than the controls （1.87 ± 0.68）,（t=-9.71,P〈 0.01）.（2）There is not diference on CDa/CD8 value from gender, age, smoking and drinking or not （t=-1.90, -0.09, 1.40, 0.395 respectively, P〉 0.05） .（3）There is significant difference on CD4/CD8 value in case groups between employing immunomodulator and not employing immunomodulator （t=2.81, P〈 0.05）, and the former＇s value is lower significantly than the later＇s; There is not difference between applying glucocorticoid and not applying （t=1.097, P〈 0.05）; There is not correlativity among the total amount of hormone, daily mean amount, odd-numbered days maximal dose, time of using hormone and CD4/CD8 value （r=-0.21, 0.162, 0.073, -0.125 respectively, P 〉0.05）.（4�

关 键 词：SARS 预后2年 CD4/CD8 

分 类 号：R446.61[医药卫生—诊断学]