新型冠状病毒肺炎患者实验室检测指标与免疫学特征分析  

Analysis of laboratory detection markers and immunological characteristics of patients with Coronavirus disease 2019

作　　者：董艳迎 李妙羡[1] 朱建宏[1] 孟昊[1] 刘海龙[1] 张华 高宁[1] 张磊[1] 党双锁[1] 耿燕[1] DONG Yanying;LI Miaoxian;ZHU Jianhong;MENG Hao;LIU Hailong;ZHANG Hua;GAO Ning;ZHANG Lei;DANG Shuangsuo;GENG Yan(Clinical Laboratory,The Second Affiliated Hospital of Xi'an Jiaotong University,Xi'an,Shanxi,China,710004)

机构地区：[1]西安交通大学第二附属医院检验科,陕西西安710004

出　　处：《分子诊断与治疗杂志》2020年第6期697-700,714,共5页Journal of Molecular Diagnostics and Therapy

基　　金：国家自然科学基金青年项目(81801581);陕西省重点研发计划(2019SF-159和S2020-YF-YBSF-1279)。

摘　　要：目的分析新型冠状病毒肺炎,即2019冠状病毒病(COVID-19)患者实验室检测指标与免疫学功能指标的变化水平,并探讨其临床应用价值。方法回顾性研究2020年1月至2020年3月在我院住院的6例新型冠状病毒肺炎确诊患者的实验室检测结果,探索患者常规实验室检查与免疫学功能指标包括T淋巴细胞亚群及细胞因子的变化规律。结果①血常规结果显示COVID-19患者的淋巴细胞计数较正常对照组明显降低(P<0.05)。红细胞沉降率、纤维蛋白原、D-二聚体、谷丙转氨酶、谷草转氨酶、胱抑素C、乳酸脱氢酶、羟丁酸脱氢酶、C-反应蛋白水平较正常对照组显著上升(P<0.05)。②COVID-19患者免疫功能指标分析结果显示外周血CD3+T、CD4+T及CD8+T淋巴细胞计数较正常对照组明显降低(P<0.05)。炎症因子IL-2R、IL-6、IL-8、IL-10和TNF-α较正常对照组显著增高(P<0.05)。结论 T淋巴细胞下降和细胞因子风暴的出现是COVID-19患者重要的免疫学特征,动态观察COVID-19患者各项实验室及免疫功能指标对评估机体免疫状态、早期识别新冠病毒感染诱发的细胞因子风暴及监测疗效均具有重要意义。Objective To analyze the changes of laboratory detection markers and immunological function markers for patients with Coronavirus disease 2019(COVID-19),and to explore its clinical application value.Methods Routine and immune laboratorial data in six confirmed cases from in-patients with COVID-19 between January,2020 and March,2020 in our hospital were retrospective studied.The changes of common and immune function indexes including T lymphocyte subsets and various cytokines were detected and analyzed.Results①Blood routine examination showed that the lymphocyte counts of the COVID-19 patients were significantly lower than those of the normal control(P<0.05).②ESR,FIB,D-D,ALT,AST,CysC,LDH,HBDH and CRP increased significantly than those of the normal control(P<0.05).COVID-19 patients exhibited a remarkable decline of lymphocytes counts including CD3+、CD4+and CD8+T cells,and significant up-regulation of cytokines including IL-2R、IL-6、IL-8、IL-10 and TNF-α(P<0.05).Conclusion The decrease of T lymphocytes and the appearance of cytokine storm are important immunological characteristics of COVID-19 patients.Dynamic observation of various laboratory and immune function indicators of COVID-19 patients can be used to evaluate the immune status.Early identification of cytokine storm induced by COVID-19 and monitoring the efficacy is of great significance.

关 键 词：新型冠状病毒肺炎 新型冠状病毒 免疫功能紊乱 临床预警指标 

分 类 号：R563.1[医药卫生—呼吸系统] R446[医药卫生—内科学]