Bofill M, Janossy G, Lee C A, MacDonald-Burns D, Phillips A N, Sabin C, Timms A, Johnson M A, Kernoff P B
Department of Clinical Immunology, Royal Free Hospital and School of Medicine, London, England.
Clin Exp Immunol. 1992 May;88(2):243-52. doi: 10.1111/j.1365-2249.1992.tb03068.x.
With the advent of standard flow cytometric methods using two-colour fluorescence on samples of whole blood, it is possible to establish the ranges of CD3, CD4 and CD8 T lymphocyte subsets in the routine laboratory, and also to assist the definition of HIV-1-related deviations from these normal values. In 676 HIV-1-seronegative individuals the lymphocyte subset percentages and absolute counts were determined. The samples taken mostly in the morning. The groups included heterosexual controls, people with various clotting disorders but without lymphocyte abnormalities as well as seronegative homosexual men as the appropriate controls for the HIV-1-infected groups. The stability of CD4% and CD8% values was demonstrated throughout life, and in children CD4 values less than 25% could be regarded as abnormal. The absolute counts of all T cell subsets decreased from birth until the age of 10 years. In adolescents and adults the absolute numbers (mean +/- s.d.) of lymphocytes, CD3, CD4 and CD8 cells were 1.90 +/- 0.55, 1.45 +/- 0.46, 0.83 +/- 0.29 and 0.56 +/- 0.23 x 10(9)/l, respectively. In patients with haemophilia A and B the mean values did not differ significantly. In homosexual men higher CD8 levels were seen compared with heterosexual men and 27% had an inverted CD4/CD8 ratio but mostly without CD4 lymphopenia (CD4 less than 0.4 x 10(9)/l). However, some healthy uninfected people were 'physiologically' lymphopenic without having inverted CD4/CD8 ratios. When the variations 'within persons' were studied longitudinally over a 5-year period, the absolute CD4 counts tended to be fixed at different levels. As a marked contrast, over 60% of asymptomatic HIV-1+ patients exhibited low CD4 counts less than 0.4 x 10(9)/l together with inverted CD4/CD8 ratios. Such combined changes among the heterosexual and HIV-1-seronegative homosexual groups were as rare as 1.4% and 3%, respectively. For this reason, when the lymphocyte tests show less than 0.4 x 10(9)/l CD4 count and a CD4/CD8 ratio of less than unity, the individuals need to be investigated further for chronicity of this disorder, the signs of viral infections such as HIV-1 and other causes of immunodeficiency.
随着全血样本双色荧光标准流式细胞术方法的出现，在常规实验室中确定CD3、CD4和CD8 T淋巴细胞亚群的范围成为可能，同时也有助于明确与HIV-1相关的偏离这些正常值的情况。对676名HIV-1血清阴性个体的淋巴细胞亚群百分比和绝对计数进行了测定。样本大多在早晨采集。这些组包括异性恋对照者、患有各种凝血障碍但无淋巴细胞异常的人以及血清阴性同性恋男性，作为HIV-1感染组的合适对照。整个生命过程中CD4%和CD8%值的稳定性得到了证实，儿童中CD4值低于25%可视为异常。所有T细胞亚群的绝对计数从出生到10岁逐渐减少。在青少年和成年人中，淋巴细胞、CD3、CD4和CD8细胞的绝对数量（平均值±标准差）分别为1.90±0.55、1.45±0.46、0.83±0.29和0.56±0.23×10⁹/L。在甲型和乙型血友病患者中，平均值无显著差异。与异性恋男性相比，同性恋男性的CD8水平更高，27%的人CD4/CD8比值倒置，但大多没有CD4淋巴细胞减少（CD4低于0.4×10⁹/L）。然而，一些健康未感染的人“生理性”淋巴细胞减少，但CD4/CD8比值未倒置。当在5年期间纵向研究“个体内部”的变化时，CD4绝对计数倾向于固定在不同水平。形成鲜明对比的是，超过60%的无症状HIV-1阳性患者表现出CD4计数低于0.4×10⁹/L且CD4/CD8比值倒置。这种异性恋和HIV-1血清阴性同性恋组中的联合变化分别仅为1.4%和仅为3%。因此，当淋巴细胞检测显示CD4计数低于0.4×10⁹/L且CD4/CD8比值小于1时，需要对个体进行进一步调查，以确定这种疾病的慢性情况、HIV-1等病毒感染的迹象以及其他免疫缺陷原因。
