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[北京1291例严重急性呼吸综合征的免疫学特征]

[Immunological characteristics of 1291 cases of severe acute respiratory syndrome in Beijing].

作者信息

Huang Ci-bo, Wang Qian, Xie Gao-qiang, Liu Ai-hua, Lai Bei, Chen Ying-juan, Cheng Yong-jing, Xu Hua, Han De-min

机构信息

Department of Rheumatology, Beijing Hospital, Beijing 100730, China.

出版信息

Zhonghua Nei Ke Za Zhi. 2004 Jun;43(6):406-9.

Abstract

OBJECTIVE

To investigate the immunological characteristics of the cases of severe acute respiratory syndrome (SARS) in Beijing City.

METHODS

Clinical data of 1291 patients with SARS from March to July 2003 in Beijing City were retrospectively analyzed.

RESULTS

In patients with SARS, the absolute numbers of white blood cells, lymphocytes and CD(3), CD(4) and CD(8) lymphocyte subsets decreased during the early period of the disease, being manifested in 56.91%, 88.26%, 47.96%, 45.56% and 41.10% of the patients, respectively. During the first 3 days the median numbers of CD(3), CD(4) and CD(8) were 425 x 10(6)/L, 223 x 10(6)/L, 170 x 10(6)/L, respectively, being the lowest values in the course of the disease. During the second week the corresponding numbers were 536 x 10(6)/L, 267 x 10(6)/L, 224 x 10(6)/L, respectively; they returned to normal by the fourth week (P < 0.05), showing a trend of gradual increase during the disease progression. Comparison of different time points of the same cases also showed that CD(3), CD(4) and CD(8) were lowest in the first 1 - 3 days. The median number of CD(3) was higher (954 x 10(6)/L) during week 3, and there was no significant difference among other 3 weeks (P > 0.05). In the early period of the disease the CRP increased but ESR, C(3) and C(4) were still in normal ranges.

CONCLUSIONS

In the early period of SARS, the WBC, lymphocytes, CD(3), CD(4) and CD(8) lymphocyte subsets decreased remarkably, and they tended to increase as the disease progressed. Simultaneous decreases in CD(3), CD(4) and CD(8) during the first week is a characteristic immunological change, which may facilitate the early diagnosis of SARS.

摘要

目的

探讨北京市严重急性呼吸综合征(SARS)病例的免疫学特征。

方法

回顾性分析2003年3月至7月北京市1291例SARS患者的临床资料。

结果

SARS患者在疾病早期白细胞、淋巴细胞及CD(3)、CD(4)和CD(8)淋巴细胞亚群的绝对数均下降,分别有56.91%、88.26%、47.96%、45.56%和41.10%的患者出现上述情况。在发病的前3天,CD(3)、CD(4)和CD(8)的中位数分别为425×10⁶/L、223×10⁶/L、170×10⁶/L,为病程中的最低值。在第二周,相应数值分别为536×10⁶/L、267×10⁶/L、224×10⁶/L;到第四周恢复正常(P<0.05),在疾病进展过程中呈逐渐上升趋势。对同一病例不同时间点进行比较也显示,CD(3)、CD(4)和CD(8)在发病的第1至3天最低。第3周CD(3)的中位数较高(954×10⁶/L),其他3周之间无显著差异(P>0.05)。在疾病早期CRP升高,但ESR、C(3)和C(4)仍在正常范围内。

结论

SARS早期白细胞、淋巴细胞、CD(3)、CD(4)和CD(8)淋巴细胞亚群显著下降,且随疾病进展呈上升趋势。发病第一周CD(3)、CD(4)和CD(8)同时下降是其免疫学特征性变化,可能有助于SARS早期诊断。

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