H1N1患者疾病早期CD4^+T细胞减少及其临床意义  

Decrease of CD4^+T lymphocytes in patients with H1N1 in early stage and its clinical significances

作　　者：左凌云[1] 赵伟[1] 赵红[1] 俞海英[1] 孙薇薇[1] 

机构地区：[1]东南大学附属第二医院感染科,江苏南京210003

出　　处：《吉林大学学报（医学版）》2010年第5期979-981,共3页Journal of Jilin University：Medicine Edition

基　　金：江苏省南京市科技局社会发展项目资助课题(200804041)

摘　　要：目的:观察H1N1患者在疾病早期CD4+T细胞改变及其在疾病的发展及治疗选择中的意义。方法:应用流式细胞术对48例发病10d内确诊为H1N1患者的外周血标本进行T细胞亚群的绝对计数检测,并动态观察肺部CT病变的变化。结果:在48例患者中,有28例患者CD4+T细胞绝对计数在正常范围内,病变范围小,病情呈稳定状态,不需要肾上腺糖皮质激素治疗。另有20例患者CD4+T细胞的绝对值低于正常,其中有4例患者病情呈进展状态,加用肾上腺糖皮质激素治疗;有16例患者CD4+T细胞绝对计数轻度减低,病情处于稳定状态,未加用肾上腺皮质激素治疗。Pearson相关性分析结果显示:CD4+T细胞数与肺内病变程度呈负相关关系(r=-0.299,P<0.05),与糖皮质激素使用率呈负相关关系(r=-0.383,P<0.05)。结论:H1N1患者发病早期外周血CD4+T细胞绝对计数愈低,肺内病变的程度愈重;CD4+T细胞绝对计数下降明显者需要糖皮质激素治疗。Objective To observe the change of CD4＋ T Lymphocytes in patients with H1N1at early stage and figure out its clinical significances on the progress and therapeutic selection of H1N1.Methods The absolute counts of T lymphocyte subset from the peripheral blood samples of 48H1N1patients in first ten days＇duration were detected by flow cytometry,and the serial chest CT examinations were performed.Results In all 48clinical cases,28cases were in normal range of CD4＋lymphocyte absolute count,whose pulmonary lesions were limited and illness condition stayed in the stability,they didn＇t need steroid.In the other 20cases with low level of CD4＋,4cases＇illness presented the progressive development and needed to be treated with steroid and 16cases with lightly decreased CD4＋level which had a stable condition without treatment with steroid.The result of Pearson correlation analysis showed that there were negative correlations between absolute count of CD4＋cells and pulmonary lesions （r=-0.299,P〈0.05）and steroid treatment（r=-0.383,P〈0.05）.Conclusion The lower peripheral blood CD4＋cell absolute count of H1N1patients at early stage indicates the worse condition of pulmonary lesions.The patients with remarkable decrease of CD4＋lymphocytes are in need of treatment with steroid.

关 键 词：H1N1 CD4+ T淋巴细胞 肺部CT 糖皮质激素 

分 类 号：R512.39[医药卫生—内科学]