3例异型淋巴细胞增多患者炎症指标和免疫功能分析并文献复习  

Analysis of inflammatory markers and immune function in 3 patients with atypical lymphocytosis and literature review

作　　者：张娇 王哲[2] 张朝 付建珠 成志勇[3] ZHANG Jiao;WANG Zhe;ZHANG Zhao;FU Jianzhu;CHENG Zhiyong(Department of Infectious Diseases,Dingzhou People’s Hospital,Dingzhou Hebei 073000;Department of Laboratory,First Hospital of Baoding,Baoding Hebei 071000;Department of Hematology,First Hospital of Baoding,Baoding Hebei 071000,China)

机构地区：[1]定州市人民医院感染性疾病科,河北定州073000 [2]保定市第一医院检验科,河北保定071000 [3]保定市第一医院血液内科,河北保定071000

出　　处：《临床与病理杂志》2024年第9期1304-1310,共7页Journal of Clinical and Pathological Research

基　　金：河北省适用跟踪计划(2018091)。

摘　　要：异型淋巴细胞发生机制是由于病原体侵入机体,通过免疫应答和大量细胞因子释放,导致大量T淋巴细胞和少量B淋巴细胞异常增殖,出现形态变异,即异型淋巴细胞。定州市人民医院收治3例异型淋巴细胞增多患者,最初均考虑传染性单核细胞增多症。检查后发现:病例1为腺病毒和衣原体感染,病例2为新型冠状病毒感染,病例3为Epstein-Barr病毒感染,3例患者炎症指标降钙素原均正常,分化簇(cluster of differentiation,CD)64指数均升高,且以病例1升高明显;免疫功能指标CD4^(+)/CD8^(+)均降低,且以病例3降低明显;调节性T细胞均减低。细胞因子的检测显示:病例1以白细胞介素-6、肿瘤坏死因子-α、干扰素-γ等炎症因子表达升高,病例2各项细胞因子表达均正常,病例3白细胞介素-6、白细胞介素-8、白细胞介素-10、肿瘤坏死因子-α、干扰素-γ均明显升高。3例患者经抗感染及抗病毒治疗后均恢复正常。The mechanism of atypical lymphocytosis involves pathogen invasion triggering an immune response,leading to the release of large amounts of cytokines.This results in the abnormal proliferation and morphological variation of numerous T lymphocytes and a smaller proportion of B lymphocytes,forming atypical lymphocytes.This study discusses 3 cases of atypical lymphocytosis treated at Dingzhou People’s Hospital,initially suspected as infectious mononucleosis.After examination,Case 1 was diagnosed with adenovirus and chlamydia infection,Case 2 was diagnosed with severe acute respiratory syndrome coronavirus 2 infection,and Case 3 was diagnosed with Epstein-Barr virus infection.The procalcitonin of inflammatory indicator in the 3 patients was all normal,and the cluster of differentiation(CD)64 index was also increased,which was significantly increased in Case 1.The immune function index CD4^(+)/CD8^(+)was all reduced,which was significantly reduced in Case 3,and the regulatory T cells were all decreased.The detection of cytokine expression showed that:the expression of inflammatory factors such as interleukin-6,tumor necrosis factor-α,and interferon-γwere increased in Case 1;while the above inflammatory factors were all normal in Case 2;however,the interleukin-6,interleukin-8,interleukin-10,tumor necrosis factor-αand interferon-γwere all significantly increased in Case 3.After antibiotic and antiviral treatment,all the 3 patients returned to recovery of health.

关 键 词：异型淋巴细胞 传染性单核细胞增多症 严重急性呼吸系统综合征冠状病毒2 病毒 感染 

分 类 号：R73[医药卫生—肿瘤]