几种感染性疾病中外周血T淋巴细胞亚群变化的检测及其临床意义研究  

Changes in peripheral blood lymphocyte subsets in some infectious diseases and its clinical significance

作　　者：李媛媛[1] 张舒 曹波 陆晓晔[1] 刘黎[1] 陈杰[1] 归茜[1] 徐欣晖[1] 吕利雄[1] 朱长清[1] 

机构地区：[1]上海交通大学医学院附属仁济医院急诊科,上海200127 [2]上海汇中细胞生物科技有限公司,上海201615

出　　处：《诊断学理论与实践》2015年第4期363-366,共4页Journal of Diagnostics Concepts & Practice

基　　金：上海市科委重点科技攻关项目(10441900200)

摘　　要：目的:检测几种常见感染性疾病患者的外周血T淋巴细胞亚群变化,探讨其在疾病中的特点及临床意义。方法:采用SemiBioCD系列(CD3/CD4/CD8)细胞检测玻片,检测166例常见感染性疾病患者(57例社区获得性肺炎、67例脓毒症、42例慢性阻塞性肺疾病急性加重期)及55名正常对照者外周血CD3+、CD4+、CD8+T细胞的绝对计数及比值,结合其IgG、IgM、IgA、C反应蛋白变化,并监测脓毒症患者治疗前后上述指标改变。结果:社区获得性肺炎、脓毒症、慢性阻塞性肺疾病急性加重期组患者的CD3+、CD4+、CD8+T细胞绝对计数及脓毒症患者的CD4+/CD8+比值均显著低于对照组(P<0.01),而慢性阻塞性肺疾病急性加重期患者的CD4+/CD8+比值显著高于对照组(P<0.01)。脓毒症患者治疗后CD4+、CD8+T细胞绝对计数及CD4+/CD8+比值均较治疗前显著升高(P<0.01)。脓毒症患者的C反应蛋白显著高于对照组,且在治疗后显著降低(P<0.01)。结论:几种常见感染性疾病患者的T淋巴细胞亚群存在异常,监测其T淋巴细胞亚群的变化对治疗及预后有指导意义。Objective To study the changes in subsets of T lymphocytes in the peripheral blood of patients with some common infectious diseases, and to investigate its clinical significance. Methods： A total of 166 patients were enrolled,including 57 cases of community acquired pneumonia（CAP）, 42 cases of acute exacerbation of chronic obstructive pulmonary disease,（AECOPD）, 67 cases of sepsis, while 55 healthy volunteers were served as controls. Semi Bio CD series（CD3/4/8）cell detection slide was used to assess the absolute counting of lymphocytes（CD3＋, CD4＋, CD8＋）in peripheral blood, and CD4＋/CD8＋, Ig G, Ig M, Ig A, CRP were measured with turbidimetric inhibition immunoassay. All the above mentioned indices were assayed before and after treatment. Results： The counting of CD3＋, CD4＋, CD8＋T cells in CAP, AECOPD, sepsis patients and the CD4＋/CD8＋in sepsis patients were significantly lower than those in controls（P〈0.01）. The CD4＋/CD8＋in AECOPD was significantly higher than that in controls（P〈0.01）. The counting of CD4＋, CD8＋T cells and CD4＋/CD8＋of sepsis patients were significantly higher after treatment than before treatment（P〈0.01）. The CRP level in sepsis patients was significantly higher than that in controls, and was decreased after treatment（P 0.01）. Conclusions：Changes in subsets of CD3＋, CD4＋, CD8＋T lymphocytes exists in patients with infectious diseases and detection of these changes may be helpful for monitoring treatment and predicting prognosis.

关 键 词：T细胞亚群 社区获得性肺炎 脓毒症 慢性阻塞性肺疾病急性加重期 

分 类 号：R563.1[医药卫生—呼吸系统] R563.9[医药卫生—内科学]