舟山海岛严重发热伴血小板减少综合征淋巴细胞亚群及 CD25表达特征动态分析  

Analysis of lymphocyte subsets and interleukin-2 receptor in patients with severe fever with thrombo-cytopenia syndrome in Zhoushan island

作　　者：姚燕珍[1] 鲍舟君[1] 李世波[2] 

机构地区：[1]浙江省舟山医院检验中心, 316004 [2]浙江省舟山医院传染科, 316004

出　　处：《中华微生物学和免疫学杂志》2014年第5期359-363,共5页Chinese Journal of Microbiology and Immunology

基　　金：浙江省医药卫生平台重点资助计划（2012ZDA044）

摘　　要：目的：探讨舟山海岛地区严重发热伴血小板减少综合征（ severe fever with thrombocy-topenia syndrome，SFTS）患者淋巴细胞亚群及白细胞介素-2受体（CD25）表达的特征。方法采用血细胞分析仪、全自动生化仪及流式细胞仪分别检测SFTS患者治疗前及治疗10 d后外周血血常规、血生化、淋巴细胞亚群，统计学分析其动态变化及相关关系。结果 SFTS患者治疗前白细胞、血小板、CD3＋T细胞、CD4＋T细胞均明显低于正常体检者。治疗10 d后，白细胞、血小板均明显上升， CD3＋T细胞、CD4＋T细胞仍低于正常体检者， CD25＋细胞高于正常体检者，差异有统计学意义（ P＜0．05）；SFTS死亡组T细胞、CD4＋T细胞、CD8＋T细胞和CD25＋细胞均显著低于痊愈组，差异有统计学意义（ P＜0．05）。 CD25＋细胞和B细胞与白细胞（WBC）呈正相关，血小板（blood platelet，PLT）与CD4＋T细胞呈正相关，差异有统计学意义（P＜0．05）；谷丙转氨酶（ALT）、肌酸激酶（CK）与CD3＋、CD8＋T细胞呈正相关，差异有统计学意义（P＜0．05）。结论新型布尼亚病毒（SFTSV）感染后机体免疫细胞比例发生改变，尤其是CD4＋T细胞减少，并与WBC、PLT和多种血清酶有一定的相关关系。Objective To analyze the characteristics of lymphocyte subsets and interleukin-2 re-ceptor （CD25） in patients with severe fever with thrombocytopenia syndrome （SFTS） in Zhoushan island. Methods Automated blood analyzer , automatic biochemical analyzer and flow cytometry were used to meas-ure hematological parameters , biochemical parameters and lymphocyte subsets in patients with SFTS before and after treatment .The dynamic changes and correlation analysis were statistically analyzed .Results The counts of white blood cells （WBCs）, platelets, total T cells and CD4＋T cells in patients with SFTS before treatment were significantly lower than those in healthy subjects .The counts of WBCs and platelets were sig-nificantly increased after ten days of treatment , and the level of CD25＋cells was higher than that in control group, but the level of total T cells and CD 4＋T cells were still lower than those in healthy subjects （ P〈0.05）.Patients died of SFTS had significantly lower counts of total T cells , CD4＋T cells, CD8＋T cells and CD25＋cells than cured patients （P〈0.05）.The level of CD25＋cells and B cells were positively correlated with WBC level （P〈0.05）.Platelet level was positively correlated with the percentage of CD 4＋T cells （P〈0.05）.The level of alanine aminotransferase and creatine kinase were positively correlated with the number of CD3＋T and CD8＋T cells （P〈0.05）.Conclusion SFTS virus infection affected the percentage of body′s immune cells, especially the level of CD4＋T cells.The imbalanced immune system was correlated with the counts of WBCs , platelets and various enzymes in serum and it might be one of the factors causing extensive damage of multiple organs and tissues .

关 键 词：严重发热伴血小板减少综合征 新型布尼亚病毒 淋巴细胞亚群 白细胞介素-2受体 

分 类 号：R510[医药卫生—内科学]