[1]任云霞,贺文婷,潘龙飞,等.新型冠状病毒肺炎35例临床特征及外周血T淋巴细胞亚群水平[J].陕西医学杂志,2020,49(10):1207-1210.[doi:DOI:10.3969/j.issn.1000-7377.2020.10.002]
　REN Yunxia,HE Wenting,PAN Longfei,et al.Clinical characteristics of 35 cases of COVID-19 and levels of T lymphocyte subsets in peripheral blood[J].,2020,49(10):1207-1210.[doi:DOI:10.3969/j.issn.1000-7377.2020.10.002]
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新型冠状病毒肺炎35例临床特征及外周血T淋巴细胞亚群水平
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《陕西医学杂志》[ISSN:1000-7377/CN:61-1281/TN]

卷:
49
期数:
2020年10期
页码:
1207-1210
栏目:
“新型冠状病毒肺炎”专题
出版日期:
2020-10-05

文章信息/Info

Title:
Clinical characteristics of 35 cases of COVID-19 and levels of T lymphocyte subsets in peripheral blood
作者:
任云霞1; 贺文婷2; 潘龙飞3; 李积安4△
1.西安市胸科医院浆膜腔科(西安710100); 2.西安市第四医院急诊科(西安710004); 3.西安交通大学第二附属医院急诊科(西安710003); 4.西安市脑科医院呼吸介入科(西安 710100)
Author(s):
REN Yunxia; HE Wenting; PAN Longfei; et al.
Department of Serous Cavity,Xi'an Chest Hospital(Xi'an 710100)
关键词:
新型冠状病毒肺炎;  CD3+;  CD3+CD4+;  CD3+CD8+;  CD4+/CD8+;  T淋巴细胞
Keywords:
Corona virus disease 2019;  CD3+;  CD3+CD4+;  CD3+CD8+;  CD4+/CD8+;  Tlymphocytes
分类号:
R563.1
DOI:
DOI:10.3969/j.issn.1000-7377.2020.10.002
文献标志码:
A
摘要:
目的:探讨新型冠状病毒肺炎(COVID-19)患者的临床特征及外周血T淋巴细胞亚群的水平。方法:收集确诊的COVID-19患者(观察组)35例临床资料进行回顾性研究,对 T淋巴细胞亚群数值及同期30例健康查体患者(对照组)的T淋巴细胞亚群的数值,进行统计学分析; 依据新型冠状病毒肺炎诊疗方案(试行第六版)将病例分为普通组和重症组。结果:35例确诊患者中男性15例,女性20例,男女比3:4; 年龄21～82岁,≥50岁 21 例(60%),50 岁以下14例(40%); 合并高血压5例,糖尿病3例,冠心病1例,有明确接触史20例,占57.1%; 发热为首发症状28例,占 80%; 咳嗽18例,占51.4%,多以干咳为主,4例咳少量白痰,1例咳多量黄痰; 乏力16例,占45.7%; 腹泻4例,占11.4%; 肝功能异常15例,占42.9%; 心肌酶异常2例,占5.7%; 凝血四项异常3例,占5.3%。发病至入院平均5.54 d,3 d内入院14例(40%),7 d后入院13例(37.1%); 平均住院天数为17.62 d; 观察组血沉平均值57.66 mm/h,观察组C反应蛋白均值38.75 mg/L,二者较对照组均升高显著,差异具有统计学意义(P<0.05),而降钙素原均值0.087 μg/L,与对照组相比,差异无统计学意义(P>0.05)。与对照组相比,观察组的淋巴细胞数值及白细胞计数下降显著,差异具有统计学意义(P<0.05),而淋巴细胞比例降低,差异无统计学意义(P>0.05),CD3+、CD3+CD4+及 CD4+/CD8+下降显著,差异具有统计学意义(P<0.05),而CD3+CD8+T淋巴细胞下降差异无统计学意义(P>0.05)。与普通组相比,重症组的CD3+下降显著,差异具有统计学意义(P<0.05),而CD3+CD4+ 、CD3+CD8+、CD4+/CD8+ T淋巴细胞下降,差异无统计学意义(P>0.05)。结论:COVID-19患者大多以发热为首发症状,多有明确接触史,实验室检查为血沉及C反应蛋白明显增高,降钙素原无明显变化,而外周血CD3+、CD3+CD4+ T淋巴细胞数量明显下降。CD3+T淋巴细胞数值可作为早期预测COVID-19重型的指标,需重点监测和关注。
Abstract:
Objective:To investigate the clinical characteristics of patients with COVID-19 and the levels of T lymphocyte subsets in peripheral blood.Methods:The clinical data of 35 confirmed patients with COVID-19(observation group)were collected for retrospective study.The values of T lymphocyte subsets in the observation group and the control group(35 healthy patients at the same time)were statistically analyzed.According to the COVID-19 diagnosis and treatment plan(trial version 6),the cases were divided into ordinary group and severe group.Results:Among the 35 confirmed patients,there were 15 males and 20 females,and the male to female ratio was 3:4; the age distribution was 21 to 82 years old,21 cases(60%)were ≥ 50 years old,and 14 cases(40%)were under 50 years old; with hypertension(5 cases),diabetes(3 cases),coronary heart disease(1 case),with a clear history of exposure(20 cases),accounting for 57.1%; fever was the first symptom(28 cases),accounting for 80%; cough(18 cases),accounting for 51.4%,mostly dry cough,4 cases with a small amount of white sputum,1 case with a lot of yellow sputum; fatigue(16 cases),accounting for 45.7%; diarrhea(4 cases),accounting for 11.4%; abnormal liver function(15 cases),accounting for 42.9%; myocardial enzyme abnormalities(2 cases),accounting for 5.7%; four coagulation abnormalities (3 cases),accounting for 5.3%.The average time from onset to admission was 5.54 days,14 patients(40%)were admitted within 3 days,and 13 patients(37.1%)were admitted after 7 days; the average hospital stay was 17.62 days.The mean ESR was 57.66 mm/h,and the mean value of C reactive protein was 38.75 mg/L in the observation group,both of which were significantly higher than those in the control group(P<0.05).The mean value of procalcitonin was 0.087 μg/L in the observation group,which was not statistically significant compared with that in the control group(P<0.05).Compared with the control group,the lymphocyte value and white blood cell count of the observation group decreased significantly(P<0.05); the lymphocyte ratio of the observation group decreased,which was not statistically significant(P>0.05); CD3+,CD3+CD4+,CD4+/ CD8+ decreased significantly(P<0.05),which was statistically significant,while CD3+ CD8+ T lymphocytes did not decrease significantly(P>0.05).Compared with the normal group,the CD3+ decrease in the severe group,which was statistically significant(P>0.05); the decrease of CD3+CD4+,CD3+CD8+,CD4+/CD8+ T lymphocytes was not statistically significant(P>0.05).Conclusion:Most patients with COVID-19 have fever as the first symptom and have a clear history of exposure.In laboratory tests,ESR and C reactive protein are significantly increased,and the increase in procalcitonin is not statistically significant.The number of CD3+,CD3+CD4+ T lymphocytes decrease significantly.The CD4+ T lymphocyte value can be used as an indicator for early prediction of severe cases,which needs to be monitored and paid attention to.

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更新日期/Last Update: 2020-10-10