人腺病毒55型感染肺部病变与外周血淋巴细胞关系研究

目的:探讨人腺病毒55型感染肺部病变与外周血淋巴细胞改变的关系及致病意义。方法:以50例经胸部CT证实为腺病毒肺炎的患者为研究对象(肺炎组),调查其外周血细胞及T淋巴细胞亚群变化情况,并与同期腺病毒55型感染未出现肺部病变的患者30例(非肺炎组)对照;亚组分析50例肺炎组中多肺叶病变与单肺叶病变患者之间T淋巴细胞变化的差异。结果:与非肺炎组患者相比,肺炎组患者急性期外周血淋巴细胞比例明显降低、单核细胞比例明显升高(P0.01);肺炎组CD3+T淋巴细胞比例、CD3+CD4+T淋巴细胞比例及CD4/CD8比值较非肺炎组均有明显降低(P0.01)。亚组分析显示,肺炎组患者肺部病变范围不同,T淋巴细胞亚群的变化亦有差异,多肺叶病变组患者CD3+CD8+T淋巴细胞比例较单肺叶病变组明显升高、CD4/CD8比值较单肺叶病变组明显降低(P0.05)。结论:HAdv-55感染引起肺炎病变时,宿主存在明显的细胞免疫功能受损,且与肺部病变程度有一定正相关。

The Relationship of Lung Lesions and Peripheral Blood Lymphocytes inPatients Infected with Human Adenovirus Type 55

Objective:To explore the relationship between and pathogenic significance of lung lesions and peripheral bloodlymphocytes in patients infected with human adenovirus type 55 (HAdv-55).Methods:The changes of peripheral blood cells and Tlymphocyte subsets were investigated in 50 patients with adenovirus pneumonia confirmed by chest CT scan (Group pneumonia),compared with 30 patients without lung lesions in the same period of adenovirus type 55 infection (Group non-pneumonia). Thedifferences between the changes of T lymphocytes in pneumonia cases of multiple lung lesions and single lobe lesions were analyzed.Results:Compared with that of non-pneumonia patients, the decreased peripheral blood lymphocyte proportion and increased monocyteproportion were found in acute period patients with pneumonia infected with HAdv-55 (P<0.01). The CD3+T lymphocyte proportion,CD3+CD4+T lymphocyte proportion and CD4/CD8 ratio in patients with pneumonia were significantly lower than that in non-pneumoniacases (P<0.01). Subgroup analysis showed that, the changes of T lymphocyte subsets were different between cases with multiplepulmonary lobes lesions and that with single lobe lesions. The CD3+CD8+T lymphocytes proportions in patients with multiple lobeslesions were significantly higher and CD4/CD8 ratio lower than that of patients with single lobe lesions respectively (P<0.05).Conclusion:Our data shows that the host cell immune function has been impaired, which is positively related to the degree of pulmonarylesions in patients infected with HAdv-55.