论文部分内容阅读
目的 观察严重急性呼吸综合征 (SARS)患者外周血淋巴细胞绝对细胞数和细胞因子在发病过程中的动态变化 ,了解SARS患者机体的免疫状态。方法 用酶联免疫吸附法 (ELISA)动态检测 2 1例SARS患者发病过程中血浆细胞因子IFN α、TNF α、IFN γ、IL 12和IL 10的水平。结果 分别有 6 6 7%的患者外周血淋巴细胞绝对细胞数、38 1%的患者血浆IFN α水平和 6 1 9%的患者血浆TNF α水平在发病中期达到高峰。部分患者Th1细胞因子IL 12和IFN γ有所升高 ,而所有患者整个检测时间内Th2细胞因子IL 10的产生未受到影响。 85 7%的患者发病后血浆IFN α的首次检测值 (16 1 0 9± 132 6 9pg/ml)显著低于正常值 (86 7 18± 30 6 5 0 pg/ml,P <0 0 5 )。结论 SARS病毒感染后机体的免疫反应在病程中期可能最强 ,且可能以Th1反应为主。血浆IFN α首次检测值显著低于正常值的特征可作为SARS早期诊断的依据。
Objective To observe the dynamic changes of the absolute number of peripheral blood lymphocytes and cytokines during the pathogenesis of patients with severe acute respiratory syndrome (SARS) and to understand the immune status of SARS patients. Methods The level of plasma cytokines IFNα, TNFα, IFNγ, IL 12 and IL 10 in 21 SARS patients were detected dynamically by enzyme-linked immunosorbent assay (ELISA). The results showed that there were 6 6 7% of the absolute number of peripheral blood lymphocytes, 38 1% of patients with plasma IFN α levels and 6 1 9% of patients with plasma TNF α levels peaked in the metaphase. In some patients, the Thl cytokines IL12 and IFNγ were elevated, whereas the production of Th2 cytokine IL-10 was unaffected in all patients over the entire test period. The first detection of plasma IFNα after onset of the disease in 857% (16 1 0 9 ± 132 6 9 pg / ml) was significantly lower than the normal value (86 7 18 ± 30 6 5 0 pg / ml, P 0 05) . Conclusion The body’s immune response after SARS virus infection may be the strongest in the middle of the course of disease, and may be mainly Th1 reaction. The characteristics of the first detection of plasma IFN-αin the first time lower than the normal value can be used as the basis for the early diagnosis of SARS.