Li Ming-hui, Li Xing-hong, Li Xing-wang, Ma Lie, Yi Wei, Jiang Yu-yong, Dong Jian-ping, Li Wei-li
Beijing Ditan Hospital, Beijing 100011, China.
Zhonghua Shi Yan He Lin Chuang Bing Du Xue Za Zhi. 2004 Jun;18(2):137-41.
To clarify the difference and significance of T-lymphocyte subsets in differential diagnosis between severe acute respiratory syndrome SARS) and common atypical pneumonia.
Totally 100 patients hospitalized in Beijing Ditan Hospital since March to June 2003 with clinical diagnosis of SARS were involved in this study. These patients courses of disease were over 3 weeks. These patients were divided into two groups, SARS group and common atypical pneumonia group (non-SARS group). The counts of CD3+, CD4+ and CD8+ T-lymphocyte of two groups were systematically recorded and analyzed.
Sixty-five of the patients were confirmed to have common type of SARS, including 26 males and 39 females, 50 cases received methylprednisolone treatment. Thirty-five cases had common atypical pneumonia (non-SARS), 21 were males while 14 were females, 20 cases received methylprednisolone treatment. All the cases of two groups were cured in the end. The SARS patients T-lymphocyte counts decreased first and then increased. Before 15 days of disease course, mean CD3+, CD4+, CD8+ T-lymphocyte counts of SARS patients were decreased apparently (694+/-568/microl, 441+/-356/microl, 309+/-462/microl). After 15th day of disease course, the counts gradually returned to normal CD3+, CD4+, CD8+ T-lymphocyte counts of non-SARS patients were normal. Compared with patients of the same group who were not treated with glucocorticoids, T-lymphocyte counts of non-SARS patients treated with glucocorticoids had no obvious difference. But glucocorticoids had some effect on SARS patients recovery of cellular immune function, i.e., it delayed the recovery by about 6 days.
With or without treatment with glucocorticoids,the lowered CD3+, CD4+, CD8+ T-lymphocyte counts in the early stage are of very important significance in differential diagnosis between severe acute respiratory syndrome and common atypical pneumonia.
明确严重急性呼吸综合征（SARS）与普通非典型肺炎鉴别诊断中T淋巴细胞亚群的差异及意义。
选取2003年3月至6月在北京地坛医院住院治疗、临床诊断为SARS且病程超过3周的100例患者，分为SARS组和普通非典型肺炎组（非SARS组），系统记录并分析两组患者CD3⁺、CD4⁺和CD8⁺T淋巴细胞计数。
确诊普通型SARS患者65例，其中男26例，女39例，50例接受甲泼尼龙治疗；普通非典型肺炎（非SARS）患者35例，其中男21例，女14例，20例接受甲泼尼龙治疗。两组患者均治愈。SARS患者T淋巴细胞计数先下降后上升，病程15天前，SARS患者CD3⁺、CD4⁺、CD8⁺T淋巴细胞平均计数明显降低（694±568/μl、441±356/μl、309±462/μl）；病程15天后，计数逐渐恢复正常。非SARS患者CD3⁺、CD4⁺、CD8⁺T淋巴细胞计数正常。与未用糖皮质激素治疗的同组患者相比，用糖皮质激素治疗的非SARS患者T淋巴细胞计数无明显差异。但糖皮质激素对SARS患者细胞免疫功能恢复有一定影响，即使其恢复延迟约6天。
无论是否使用糖皮质激素治疗，早期CD3⁺、CD4⁺、CD8⁺T淋巴细胞计数降低对严重急性呼吸综合征与普通非典型肺炎的鉴别诊断具有重要意义。
