15例新型冠状病毒肺炎患者外周血T淋巴细胞亚群变化及临床意义  

Changes of peripheral blood T lymphocyte subsets in 15 patients with COVID-19 and its clinical significance

作　　者：杨洁 杨芝芝 邓建军[1] 曾娅莉[1] 何静[1] YANG Jie;YANGZhi-zhi;DENG Jian-jun;ZENGYa-li;HE Jing(The Medical Laboratory of Sichuan Mianyang 404 Hospital,Mianyang,Sichuan 621000,China)

机构地区：[1]四川绵阳四0四医院医学检验科,四川绵阳621000

出　　处：《热带医学杂志》2021年第3期320-323,共4页Journal of Tropical Medicine

基　　金：绵阳市科技局应急科研项目(2020YJKY012)。

摘　　要：目的分析新型冠状病毒肺炎(COVID-19)患者外周血白细胞分类及T淋巴细胞亚群的变化特征。方法以收治的11例COVID-19确诊病例轻型/普通型患者(轻型/普通型COVID-19组)、4例重型/危重型患者(重型/危重型COVID-19组)、27例疑似病例(疑似组),22名健康体检者(对照组)为观察对象,回顾性分析不同组别外周血白细胞及淋巴细胞计数、T淋巴细胞亚群的表达水平。结果四组淋巴细胞绝对值及百分比呈逐项下降趋势:对照组>疑似组>轻型/普通型COVID-19组>重型/危重型COVID-19组,其中重型/危重型COVID-19组患者低于其他三组,差异有统计学意义(P<0.05)。与对照组比较,疑似组、轻型/普通型COVID-19组、重型/危重型COVID-19组CD3+、CD4+、CD8+T淋巴细胞计数均降低,其中重型/危重型COVID-19组下降最为显著(P<0.05)。重型/危重型COVID-19组CD4+/CD8+比值明显低于对照组、疑似组、轻型/普通型COVID-19组,差异有统计学意义(P<0.05)。重型/危重型COVID-19患者恢复期与急性期比较,T淋巴细胞亚群均升高(P<0.05)。结论重型/危重型COVID-19患者有明显的细胞免疫损伤,检测外周血T淋巴细胞亚群水平变化对COVID-19患者的诊断、病情进展和预后评估有重要意义。Objective To analyze the change characteristics of peripheral blood leukocyte classification and T lymphocyte subsets in patients with corona virus disease 2019(COVID-19).Methods 11 mild/ordinary patients(mild/ordinary COVID-19 group)and 4 severe/critical patients(severe/critical COVID-19 group)with COVID-19,27 suspected cases were selected as the suspected group,and 22 healthy controls were taken as control group.The count of peripheral blood leukocyte and lymphocyte and the T lymphocyte subsets in different groups were analyzed retrospectively.Results The absolute value and percentage of lymphocytes in the four groups showed a decreasing trend:the control group>the suspected group>the mild/ordinary COVID-19 group>the severe/critical COVID-19 group(P<0.05).The number of CD3+,CD4+,CD8+T lymphocytes in severe/critical COVID-19 group,mild/ordinary COVID-19 group and suspected group were lower than that in the control group,and the severe/critical COVID-19 group with the most significant decline(P<0.05).And the ratio of CD4+/CDS+in severe/critical COVID-19 group was significantly lower than that in the control group,suspected group and mild/ordinary COVID-19 group(P<0.05).In the severe/critical COVID-19 patients,the T lymphocyte subsets increased gradually during the recovery period compared with the acute stage(P<0.05).Conclusions The patients with severe/critical COVID-19 were found having cellular immunity damage markedly.It was suggested that T lymphocyte subsets might play an important role in the diagnosis,severity of illness and prognostic evaluation of COVID-19 patients.

关 键 词：COVID-19 T淋巴细胞亚群 免疫损伤 病情进展 

分 类 号：R563.1[医药卫生—呼吸系统]