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目的:研究基础疾病对严重急性呼吸综合征(SevereAcuteRespiratorySyndrome,SARS)患者免疫学指标的影响,为探讨SARS患者的发病机制、预测病情变化及为治疗提供依据。方法:收集1291例SARS患者的临床资料,建立病历数据库,记录普通合并基础疾病SARS患者发病1～5周各周的白细胞计数,淋巴细胞记数,CD3+、CD4+及CD8+T淋巴细胞绝对值,C3、C4、血沉及C反应蛋白等数据,研究各免疫学及炎性指标在普通合并基础疾病SARS患者中的不同及意义。结果:合并基础疾病SARS患者的白细胞、淋巴细胞、CD3+、CD4+及CD8+T细胞绝对值明显低于普通患者(P<0.01或P<0.05),而CRP水平明显高于普通患者(P<0.01)。结论:合并基础疾病SARS患者的T细胞免疫功能明显弱于普通SARS患者,对此类患者进行免疫支持治疗可能对改善预后具有一定意义。
Objective: To study the influence of basic diseases on the immunological parameters of patients with severe acute respiratory syndrome (SARS), to explore the pathogenesis of SARS patients, predict the changes of the disease and provide the basis for the treatment. Methods: The clinical data of 1291 SARS patients were collected. The medical record database was established. The white blood cell count, lymphocyte count, absolute value of CD3 +, CD4 + and CD8 + T lymphocytes in each week of 1 ~ 5 weeks of SARS patients with common underlying diseases were recorded. C3, C4, erythrocyte sedimentation rate and C-reactive protein and other data to study the immunological and inflammatory indicators in the common basis of SARS patients with different diseases and their significance. Results: The absolute values of leucocyte, lymphocyte, CD3 +, CD4 + and CD8 + T cells in SARS patients with underlying diseases were significantly lower than those in normal patients (P <0.01 or P <0.05), while CRP levels were significantly higher in patients with SARS than in normal patients (P <0.01) ). Conclusion: The immune function of T cells in SARS patients with underlying diseases is significantly weaker than that of SARS patients. Immunosuppressive therapy for these patients may have some significance in improving prognosis.