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目的 :探讨不同转归 (治愈 死亡 )严重急性呼吸综合征 (severeacuterespiratorysyndrome,SARS)患者病程中免疫学指标变化趋势的差异 ,以指导临床诊治和判断预后。方法 :应用SARS病历数据库 ,收集治愈和死亡SARS患者病程前 4周CD3、CD4、CD8淋巴细胞绝对值 ,CD4 CD8比值 ,淋巴细胞百分比数据 ,比较不同转归SARS患者免疫学指标的变化趋势及差异。结果 :治愈组和死亡组SARS患者CD3,CD4 ,CD8计数在起病的 1～ 2周内明显低于正常值。但治愈组各免疫学指标从第 2周起呈逐渐恢复趋势 ,而死亡组则一直呈明显降低趋势 ,第 2周仍无恢复且显著低于治愈组 (P <0 0 5 ) ,并随病程延长显著性差异更大 (P <0 0 1,P <0 0 0 1) ;CD4 CD8比值在病程中基本不变 ,无显著性组间差别。结论 :CD3、CD4、CD8淋巴细胞亚群绝对值的动态变化是判断疗效和预后的重要依据
OBJECTIVE: To investigate the difference of the immunological indexes in the course of different severe acute respiratory syndrome (SARS) patients with different outcomes (cure-and-death) to guide the clinical diagnosis and prognosis. Methods: The SARS patient record database was used to collect the absolute values of CD3, CD4, CD8 lymphocyte count, CD4 CD8 and lymphocyte percentage 4 weeks before the course of the course of the cured and died SARS patients, and to compare the change trend and difference of immunological indexes between different SARS patients . Results: The counts of CD3, CD4 and CD8 in SARS patients in the cured and dead groups were significantly lower than normal values within 1-2 weeks of onset. However, the immunological indexes in the healing group showed a gradual recovery trend from the second week, while those in the death group showed a trend of decreasing significantly, no recovery in the second week and significantly lower than that in the cured group (P <0.05) (P <0.01, P <0.01). The ratio of CD4 CD8 remained unchanged in the course of the disease, with no significant difference between groups. Conclusion: The dynamic change of absolute value of CD3, CD4, CD8 lymphocyte subsets is an important basis for judging efficacy and prognosis