新型冠状病毒肺炎患者外周血淋巴细胞亚群计数动态观察  

Dynamic observation of lymphocyte subsets in peripheral blood of patients with COVID-19

作　　者：赵本南 刘大凤 杜清 陈红 刘亚玲 王玥莲 李青峰 张仁卿 ZHAO Bennan;LIU Dafeng;DU Qing;CHEN Hong;LIU Yaling;WANG Yuelian;LI Qingfeng;ZHANG Renqing(The Public and Health Clinical Center of Chengdu,Chengdu 610061,China)

机构地区：[1]成都市公共卫生临床医疗中心,四川成都610061

出　　处：《山东医药》2021年第6期1-5,共5页Shandong Medical Journal

基　　金：四川省科技厅应对新型冠状病毒科技攻关应急项目(2020YFS0564);四川省科技厅应用基础计划项目(2016JY0008);成都市卫健委项目(2020040)。

摘　　要：目的观察新型冠状病毒肺炎(corona virus disease 2019,COVID-19;以下简称新冠肺炎)患者外周血淋巴细胞亚群计数的动态变化。方法纳入39例新冠肺炎患者,其中轻型、普通型患者(轻症)26例,重型、危重型患者(重症)13例。分别于入院时、治愈出院时、治愈1个月、治愈2个月及治愈3个月时采集外周静脉血,使用流式细胞仪检测淋巴细胞亚群[CD4^(+)T、CD8^(+)T、CD4^(+)T/CD8^(+)T、B(CD19^(+))细胞及NK(CD56^(+))细胞]。另选择健康体检者30例,采集外周静脉血检测T淋巴细胞亚群。结果 (1)与入院时、治愈出院及治愈1个月时比较,治愈2个月时轻症患者外周血CD4^(+)T计数及CD8^(+)T计数升高(P均<0.05);与治愈2个月时比较,治愈3个月时轻症患者外周血CD4^(+)T计数及CD8^(+)T计数升高(P均<0.05)。与入院时、治愈出院时、治愈1个月及治愈2个月时比较,治愈3个月时重症患者外周血CD4^(+)T计数、CD8^(+)T计数升高(P均<0.05)。与轻症患者比较,入院时重症患者外周血CD4^(+)T计数、CD8^(+)T计数低,治愈出院时外周血CD4^(+)T计数低(P均<0.05)。(2)与入院时、治愈出院、治愈1个月时及治愈2个月时比较,治愈3个月时新冠肺炎患者外周血B细胞计数、NK细胞计数升高(P均<0.05)。(3)与健康对照者比较,治愈3个月时新冠肺炎患者CD4^(+)T、CD8^(+)T计数及CD4^(+)T/CD8^(+)T比较差异均无统计学意义。结论在治愈早期,新冠肺炎患者细胞免疫功能仍被抑制。随治愈时间延长,新冠肺炎患者外周血CD4^(+)T、CD8^(+)T、B细胞及NK细胞数量可能会逐渐升高。与我国其他省市健康人群比较,治愈3个月时新冠肺炎患者外周血CD8^(+)T计数已接近正常,但CD4^(+)T计数仍偏低。ObjectiveTo observe the dynamic changes of lymphocyte subsets in peripheral blood of patients with coronavirus disease 2019(COVID-19).MethodsThirty-nine cases of patients with COVID-19 were included,including 26 mild cases and 13 severe cases.Peripheral venous blood was collected at admission,at discharge,1,2 and 3 months after discharge.We used flow cytometry to detect lymphocyte subsets[CD4^(+)T,CD8^(+)T,CD4^(+)T/CD8^(+)T,and B(CD19^(+))cells,and NK(CD56^(+))cells]at different time points.In addition,30 healthy subjects were selected,and their peripheral venous blood was collected to detect T lymphocyte subsets.Results(1)CD4^(+)T count and CD8^(+)T count increased in mild patients at 2 months after discharge as compared with those at admission,at discharge,and 1 month after discharge(both P<0.05).CD4^(+)T count and CD8^(+)T count increased in mild patients at 3 months after discharge as compared with those at 2 months after discharge(both P<0.05).CD4^(+)T count and CD8^(+)T count increased in severe patients at3 months after discharge as compared with those at admission,at discharge,1 and 2 months after discharge(all P<0.05).Compared with mild patients,CD4^(+)T and CD8^(+)T count were lower in the severe patients at admission,and CD4^(+)T count was lower at discharge(all P<0.05).(2)The B cell count and NK cell count in patients with COVID-19 increased at 3 months after discharge compared with those at admission,at discharge,1 and 2 months after discharge(all P<0.05).(3)There were no significant differences in CD4^(+)T count,CD8^(+)T count or CD4^(+)T/CD8^(+)T between healthy people and patientswith COVID-19 at 3 months after discharge(all P>0.05).ConclusionsCellular immune function in COVID-19 pa-tients was still suppressed in the early stages of cure.The counts of CD4^(+)T,CD8^(+)T,B cells and NK cells in patients withCOVID-19 gradually increased over time.Compared with healthy population in other provinces and cities in China,CD8^(+)Tcount in COVID-19 patients at 3 months after discharge was close to normal,b

关 键 词：新型冠状病毒肺炎 淋巴细胞亚群 CD8^(+)T细胞 CD4^(+)T细胞 

分 类 号：R563.1[医药卫生—呼吸系统]