恙虫病患者外周T淋巴细胞亚群变化与并发症的关系

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摘要

目的探讨恙虫病患者外周T 淋巴细胞亚群变化与并发症的关系。方法选取2018年1月至2021年9月瑞金市人民医院收治的53 例恙虫病患者及50 例健康体检者作为研究对象，设立观察组与对照组。观察1 组中，恙虫病患者53 例，对照1 组中，健康体检者50 例，观察2 组中，有并发症恙虫病患者（包括单脏器损害组10 例，双脏器损害组14 例及多脏器损害组13 例）37 例，对照2 组中，无并发症恙虫病患者16 例。观察无/有并发症恙虫病患者治疗前、治疗后及健康群体的CD3+，CD4+，CD8+T 淋巴细胞，CD4+/CD8+比值等。结果观察1 组的CD3+，CD4+，CD8+T 淋巴细胞数及CD4+/CD8+比值均低于对照1 组，差异有统计学意义（P<0.05）；观察1 组治疗后的上述指标均高于治疗前，差异有统计学意义（P<0.05）；治疗前，观察2 组的上述指标与对照2 组比较，差异无统计学意义（P>0.05）；治疗后，单脏器损害组的上述指标与对照2 组比较，差异无统计学意义（P>0.05）；双脏器损害组和多脏器损害组治疗后的CD3+T 淋巴细胞数及CD4+/CD8+比值均低于对照2 组，差异有统计学意义（P<0.05）。双脏肾损害组治疗后的CD4+T 淋巴细胞数高于对照2 组，差异有统计学意义（P<0.05）。结论 T 淋巴细胞亚群参与了恙虫病发病过程，细胞免疫功能紊乱在恙虫病发病中发挥了重要的作用，早期诊断及治疗能更好地保护恙虫病患者的细胞免疫，减少并发症的发生，改善预后。

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关键词 ：恙虫病患者, 外周T 淋巴细胞亚群, 细胞免疫, 并发症

Abstract：

Objective To investigate the relationship between peripheral T lymphocyte subgroup and complications in patients with scrub typhus. Methods A total of 53 patients with scrub typhus treated in Ruijin People's Hospital from January 2018 to September 2021 and 50 healthy people took physical examination in the same period were selected as the research objects.Then establish the observation group and the control group.Observation group 1 contains 53 patients with scrub typhus. Control group 1 contains 50 healthy people. Observation group 2 contains 37 patients with complications of scrub typhus (including 10 cases in single organ damage group, 14 cases in double organ damage group and 13 cases in multiple organ damage group). Control group 2 contains 16 patients without complications of scrub typhus.CD3+, CD4+, CD8+ T lymphocytes, CD4+/CD8+ ratio were observed before and after treatment in patients with/without complications and healthy people. Results The number of CD3+, CD4+, CD8+ T lymphocyte and CD4+/CD8+ ratio of observation group 1 were lower than those of control group 1,the differences were statistically significant(P<0.05).The above indicators of observation group 1 were higher than those before treatment, the differences were statistically significant(P<0.05). There were no significant differences in the above indexes between observation group 2 and control group 2 before treatment (P>0.05). There was no significant differences in the above indexes between the single organ damage group and the control group 2 (P>0.05). The number of CD3+T lymphocytes and CD4+/CD8+ ratio in the double organ damage group and multiple organ damage group were lower than those in the control group 2, the differences were statistically significant (P<0.05). The number of CD4+T lymphocytes in the double organ damage group was higher than that of control group,the difference was statistically significant (P>0.05). Conclusion T lymphocyte subgroup participates in the pathogenesis of scrub typhus, cellular immune dysfunction plays an important role in the pathogenesis of scrub typhus, and early diagnosis and treatment can better protect the cell immunity of scrub typhus patients, reduce the occurrence of complications and improve the prognosis.

Key words： Scrub typhus patients Peripheral T lymphocyte subgroup Cellular immunity Complications

基金资助:

江西省卫生健康委科技计划项目（202140819）。

作者简介: 陈冰（1983-），男，副主任医师，研究方向：感染病学。

引用本文:

陈冰；刘桢；李勇；刘丽荣；刘升凡；罗敬福；胡永生. 恙虫病患者外周T淋巴细胞亚群变化与并发症的关系[J]. 中国当代医药, 2022, 29(18): 44-47.
CHEN Bing LIU Zhen LI Yong LIU Lirong LIU Shengfan LUO Jingfu HU Yongsheng. Relationship between changes of peripheral T lymphocyte subgroup and complications in patients with scrub typhus. 中国当代医药, 2022, 29(18): 44-47.

链接本文:

https://www.dangdaiyiyao.com/CN/ 或 https://www.dangdaiyiyao.com/CN/Y2022/V29/I18/44

[1]	Richards AL.Rickettsial vaccines：the old and the new[J].Expert Rev Vaccines，2004，3（5）：541-555.
[2]	Kumar R，Thakur S，Bhawani R，et al.Factors for Severe Outcome in Scrub Typhus：A Hospital Based Study in Sub Himalayan Region[J].J Assoc Physicians India，2018，66（5）：36-38.
[3]	史卫红，白志峰.传染病学[M].北京：人民卫生出版社，2019.
[4]	谭雪梅，刘园园，雷旭，等.恙虫病基础和临床诊治研究进展[J].中华实验和临床感染病杂志（电子版），2017，11（5）：437-440.
[5]	熊东亮，林江，陈继红，等.恙虫病并发多脏器损害167 例临床分析[J].华中科技大学学报（医学版），2005，34（4）：496-512.
[6]	Seong SY，Choi MS，Kim IS.Orientia tsutsugamushi infection：overview and immune responses[J].Microbes Infect，2001，3（1）：11-21.
[7]	Okada H，Kobune F，Sato TA，et al.Extensive lymphopenia due to apoptosis of un-infected lymphocytes in acute measles patients[J].Arch Virol，2000，145（5）：905-920.
[8]	李柏成，张剑锋.恙虫病致病机制及辅助检查研究进展[J].实用医学杂志，2019，35（16）：2669-2672.
[9]	Cho BA，Ko Y，Kim YS，et al.Phenotypic characterization of peripheral T cells and their dynamics in scrub typhus patients[J].PLoS Negl Trop Dis，2012，6（8）：e1789.
[10]	Han S，Norimine J，Palmer GH，et al.Rapid deletion of antigenspecific CD4+T cells following infection represents a strategy of immune evasion and persistence for Anaplasma marginale[J].J Immunol，2008，181（11）：7759-7769.
[11]	Green DR，Droin N，Pinkoski M.Activation-induced cell death in T cells[J].Immunol Rev，2003，193：70-81.
[12]	陈冰，胡永生，罗敬福，等.早期诊断及治疗恙虫病的临床价值[J].当代医学，2017，23（18）：37-39.
[13]	王瑞丽，戴威，程碧环，等.恙虫病的临床特征及重症恙虫病的早期诊断[J].温州医科大学学报，2017，47（11）：832-835.
[14]	黄波，戈琦，龙国梁，等.恙虫病患者发生急性肾损伤的危险因素及死亡预测因素[J].中国急救医学，2020，40（11）：1090-1094.
[15]	栗绍刚，郭东星，李静宜，等.恙虫病临床诊治特点及预防[J].寄生虫与医学昆虫学报，2019，26（2）：118-123.
[16]	郑伟强，张武英，龙尧，等.恙虫病患者血清细胞因子和外周T 淋巴细胞亚群的变化[J].医师进修杂志（内科版），2004，27（23）：32-33.
[17]	冯时，梁张，赵桂萍，等.恙虫病的免疫机制研究进展[J].生命科学研究，2016，20（3）：267-270.
[18]	Kim HR，Hwang KA，Park SH，et al.IL-7 and IL-15：biology and roles in T-Cell immunity in health and disease[J].Crit Rev Immunol，2008，28（4）：325-339.
[19]	Hauptmann M，Kolbaum J，Lilla S，et al.Protective and pathogenic roles of CD8+T lymphocytes in murine orientia tsutsugamushi infection[J].PLoS Negl Trop Dis，2016，10（9）：e0004991.