Li Zhuo, Guo Xinhui, Hao Wa, Wu Yanning, Ji Yunxia, Zhao Yanming, Liu Fang, Xie Xianchun
Institute of Hepatitis Research, Beijing You'an Hospital, Capital Medical University, Beijing 100054, China.
Chin Med J (Engl). 2003 Jul;116(7):981-4.
To observe the changes of serum interleukins (IL), T-lymphocyte subsets, and white blood cell (WBC) count in patients with severe acute respiratory syndrome (SARS), and to investigate the relationship between injured immune function, immune response and disturbed immune adjustment in SARS patients.
The levels of serum IL-2, IL-10, IL-12 and T-lymphocyte subset counts were measured in 35 clinically diagnosed SARS patients by using enzyme linked immunosorbant assay (ELISA). The relationship between the measured results and WBC count was further analyzed.
The level of serum IL was increased to a great extent in the 35 SARS patients, and the levels of serum IL-2, IL-10 and IL-12 were 242.53 (92.69) pg/ml, 77.43 (63.37) pg/ml and 65.94 (43.21) pg/ml, respectively. The level of serum IL-2 increased markedly (P < 0.01). The peripheral blood CD(3)(+), CD(4)(+) and CD(8)(+) counts were lower than normal in 23 patients (67.7%), 26 patients (74.3%) and 15 patients (42.9%), respectively. The peripheral blood WBC counts were lower than 4.0 x 10(9)/L in 10 patients, and their CD(3)(+), CD(4)(+) and CD(8)(+) counts were 583.90 (315.58) x 10(6)/L, 272.00 (94.13) x 10(6)/L and 209.00 (72.21) x 10(6)/L, respectively. The peripheral blood WBC counts were (4.0 - 10.0) x 10(9)/L in 20 patients, and their CD(3)(+), CD(4)(+) and CD(8)(+) counts were 700.00 (502.96) x 10(6)/L, 347.00 (247.58) x 10(6)/L and 322.05 (228.47) x 10(6)/L, respectively. The peripheral blood WBC counts were higher than 10.0 x 10(9)/L in 5 patients, and their CD(3)(+), CD(4)(+) and CD(8)(+) counts were 1466.00 (630.86) x 10(6)/L, 783.00 (311.14) x 10(6)/L and 640.00 (294.40) x 10(6)/L, respectively. The decreased CD(3)(+), CD(4)(+) and CD(8)(+) counts were consistent with the decreased WBC counts. The level of IL in SARS patients was significantly higher than that in patients with chronic hepatitis B (P < 0.01).
The level of serum IL is closely related to cell immunity in SARS patients. The level of serum IL is increased evidently while CD(3)(+), CD(4)(+) and CD(8)(+) counts decrease. Both serum IL and CD are associated with injury of immune function, and thus they could be regarded as a monitoring index for judging the condition of SARS patients and prescribing immune therapy.
观察严重急性呼吸综合征（SARS）患者血清白细胞介素（IL）、T淋巴细胞亚群及白细胞（WBC）计数的变化，探讨SARS患者免疫功能损伤、免疫反应及免疫调节紊乱之间的关系。
采用酶联免疫吸附试验（ELISA）检测35例临床诊断为SARS患者的血清IL-2、IL-10、IL-12水平及T淋巴细胞亚群计数，并进一步分析检测结果与WBC计数之间的关系。
35例SARS患者血清IL水平均有不同程度升高，血清IL-2、IL-10、IL-12水平分别为242.53（92.69）pg/ml、77.43（63.37）pg/ml、65.94（43.21）pg/ml，血清IL-2水平明显升高（P<0.01）。外周血CD(3)(+)、CD(4)(+)、CD(8)(+)计数低于正常者分别为23例（67.7%）、26例（74.3%）、15例（42.9%）。外周血WBC计数<4.0×10(9)/L的10例患者，其CD(3)(+)、CD(4)(+)、CD(8)(+)计数分别为583.90（315.58）×10(6)/L、272.00（94.13）×10(6)/L、209.00（72.21）×10(6)/L；外周血WBC计数在（4.0～10.0）×10(9)/L的20例患者，其CD(3)(+)、CD(4)(+)、CD(8)(+)计数分别为700.00（502.96）×10(6)/L、347.00（247.58）×10(6)/L、322.05（228.47）×10(6)/L；外周血WBC计数>10.0×10(9)/L的5例患者，其CD(3)(+)、CD(4)(+)、CD(8)(+)计数分别为1466.00（630.86）×10(6)/L、783.00（311.14）×10(6)/L、640.00（294.40）×10(6)/L。CD(3)(+)、CD(4)(+)、CD(8)(+)计数降低与WBC计数降低一致。SARS患者血清IL水平明显高于慢性乙型肝炎患者（P<0.01）。
SARS患者血清IL水平与细胞免疫密切相关，血清IL水平明显升高，同时CD(3)(+)、CD(4)(+)、CD(8)(+)计数降低。血清IL及CD均与免疫功能损伤有关，可作为判断SARS患者病情及指导免疫治疗的监测指标。
