新型冠状病毒病患者淋巴细胞亚群与CT肺炎症指数相关性分析

李妹玲; 刘丹; 杨全; 应洁; 周微

doi:10.16016/j.1000-5404.202003035

您当前的位置：

首页 >

文章列表页 >

新型冠状病毒病患者淋巴细胞亚群与CT肺炎症指数相关性分析

特别报道：新型冠状病毒病的防控(2) | 更新时间：2026-01-09

- 新型冠状病毒病患者淋巴细胞亚群与CT肺炎症指数相关性分析
- Correlation between lymphocyte subsets and CT pneumonia index in patients with coronavirus disease 2019
- 第三军医大学学报 2020年42卷第9期页码：872-878
- 作者机构：
  
  402160 重庆，重庆医科大学附属永川医院放射科
- 作者简介：
  
  [ 刘丹，E-mail:5677676@qq.com LIU Dan, E-mail:5677676@qq.com
- 基金信息：
  
  重庆市永川区自然科学基金(Ycstc2020nb0214)
- DOI：10.16016/j.1000-5404.202003035
  中图分类号： R392.3;R563.1;R814.42
- 收稿：2020-03-04，
  
  修回：2020-03-27，
  
  纸质出版：2020-05-15
- 稿件说明：
移动端阅览
李妹玲, 刘丹, 杨全, 等. 新型冠状病毒病患者淋巴细胞亚群与CT肺炎症指数相关性分析[J]. 第三军医大学学报, 2020,42(9):872-878.

Meiling LI, Dan LIU, Quan YANG, et al. Correlation between lymphocyte subsets and CT pneumonia index in patients with coronavirus disease 2019[J]. Journal of Third Military Medical University, 2020, 42(9): 872-878.
李妹玲, 刘丹, 杨全, 等. 新型冠状病毒病患者淋巴细胞亚群与CT肺炎症指数相关性分析[J]. 第三军医大学学报, 2020,42(9):872-878. DOI： 10.16016/j.1000-5404.202003035.

Meiling LI, Dan LIU, Quan YANG, et al. Correlation between lymphocyte subsets and CT pneumonia index in patients with coronavirus disease 2019[J]. Journal of Third Military Medical University, 2020, 42(9): 872-878. DOI： 10.16016/j.1000-5404.202003035.

摘要

目的

探讨2019冠状病毒病(COVID-19)患者的淋巴细胞亚群与CT肺炎症指数的相关性。

方法

收集本院2020年1-2月收治的80例经临床及核酸检测确诊的COVID-19患者资料，其中男性45例，女性35例，年龄18~89岁，平均51.2岁。按严重程度分为2组:非重症(普通型)组68例、重症(重型、危重型)组12例，分析患者的临床资料、胸部CT图像并计算肺炎症指数。观察两组不同发病阶段淋巴细胞亚群、CT肺炎症指数情况，肺炎症指数与淋巴细胞亚群之间的相关性采用Spearman分析。

结果

COVID-19患者T淋巴细胞亚群计数正常或减低，C反应蛋白、IL-6升高或正常。与非重症组比较，重症组在发病1周内、1~2周、2周以上3个时间段CD3

、CD4

值显著下降(

0.05)，CT肺炎症指数明显上升(

0.05)，在前2个时间段CD8

值明显下降(

0.05)。CT肺部炎症高峰时间主要出现在发病2周以内，肺炎开始吸收时间主要出现在发病1~3周。CT肺炎症指数与CD3

、CD4

、CD8

、Lym值均呈显著负相关(

0.05)。

结论

COVID-19患者T淋巴细胞亚群值越低，CT肺部炎症越重，病情越严重。

Abstract

Objective

To explore the correlation between lymphocyte subtypes and CT pulmonary inflammatory index in patients with coronavirus disease 2019 (COVID-19).

Methods

inical data of 80 COVID-19 patients identified by nucleic acid test and clinical symptoms admitted in our hospital from January to February 2020 were collected in this study. They were 45 males and 35 females

and at an average age of 51.2 years. According to the severity of the disease

they were divided into the non-severe group (ordinary type

=68) and the severe group (serious and critical type

=12). The clinical data

chest CT findings and pneumonia index of the patients were observed and analyzed. Spearman analysis was employed to analyze the correlation between pneumonia index and lymphocyte subtypes count.

Results

The results showed that the T lymphocyte subsets of patients with COVID-19 were normal or decreased

and the levels of C-reactive protein and IL-6 were increased or normal. During the following courses of disease

within 1 week

weeks 1~2 and 2 weeks later

counts of CD3

and CD4

T cells in the severe group were decreased significantly at above 3 periods (

0.05)

CT pulmonary inflammatory index was obviously elevated at the 3 periods (

0.05)

and CD8

T cells count was decreased during the former 2 periods (

0.05)

when compared with the non-severe group. It was found that the peak time of CT pulmonary inflammation was mainly within 2 weeks after onset

and the beginning time of pneumonia absorption was mainly within 1~3 weeks. The pneumonia index was negatively correlated with CD3

CD4

CD8

T cells and Lym counts (

0.05).

Conclusion

The lower counts of lymphocyte subsets are

the severer the CT pulmonary inflammation is

and the more serious the condition is in COVID-19 patients.

关键词

Keywords

references

[国家卫生健康委办公厅.国家中医药管理局办公室.新型冠状病毒肺炎诊疗方案(试行第七版)[EB/OL ] .[2020-03-04 ] . https://so.m.sm.cn/c/s/m.vodjk.com/mip/a/1631009.shtml https://so.m.sm.cn/c/s/m.vodjk.com/mip/a/1631009.shtml .

[National Health Commission, National Administration of Traditional Chinese Medicine. Diagnosis and treatment plan of novel coronavirus pneumonia(7th Ed)[EB/OL ] .[2020-03-04 ] . https://so.m.sm.cn/c/s/m.vodjk.com/mip/a/1631009.shtml https://so.m.sm.cn/c/s/m.vodjk.com/mip/a/1631009.shtml .

重庆市医学影像医疗质量控制中心.重庆市医学影像医疗质量控制中心关于"规范新型冠状病毒肺炎"CT检查的建议[Z].[2020-01-31].

Chongqing Medical Imaging Quality Control Center. Chongqing medical imaging quality control center of "novel coronavirus pneumonia" CT inspection recommendations[Z].[2020-01-31].

CHEN N S, ZHOU M, DONG X, et al . Epidemiological and clinical characteristics of 99 cases of 2019 novel coronavirus pneumonia in Wuhan, China: a descriptive study[J ] . Lancet, 2020, 395(10223): 507-513. DOI:10.1016/S0140-6736(20)30211-7.

XU Z, SHI L, WANG YJ, et al . Pathological findings of COVID-19 associated with acute respiratory distress syndrome[J ] . Lancet Respir Med, 2020.[Epub ahead of print ] . DOI:10.1016/s2213-2600(20)30076-x.

李太生, 邱志峰, 韩扬, 等.严重急性呼吸综合征急性期T淋巴细胞亚群异常改变[J].中华检验医学杂志, 2003, 26(5): 297-299. DOI:10.3760/j:issn:1009-9158.2003.05.012.

LI T S, QIU Z F, HAN Y, et al . The alterations of T cell subsets of severe acute respiratory syndrome during acute phase[J ] . Chin J Lab Med, 2003, 26(5): 297-299. DOI:10.3760/j:issn:1009-9158.2003.05.012.

DUNNE P J, FAINT J M, GUDGEON N H, et al . Epstein-Barr virus-specific CD8 + T cells that re-express CD45RA are apoptosis-resistant memory cells that retain replicative potential[J ] . Blood, 2002, 100(3): 933-940. DOI:10.1182/blood-2002-01-0160..

[陆雪芳, 龚威, 王莉, 等.新型冠状病毒肺炎初诊临床特征及高分辨率CT影像表现[J/OL ] .中华放射学杂志, 2020.[Epub ahead of print ] . http://rs.yiigle.com/yufabiao/1180541.htm http://rs.yiigle.com/yufabiao/1180541.htm . DOI: 10.3760/cma.j.issn.1005-1201.2020.0006 http://dx.doi.org/10.3760/cma.j.issn.1005-1201.2020.0006 ..

[LU X F, GONG W, WANG L, et al . Initial clinical features and high resolution CT images of novel coronavirus pneumonia[J/OL ] . Chin J Radiol, 2020.[Epub ahead of print ] . http://rs.yiigle.com/yufabiao/1180541.htm http://rs.yiigle.com/yufabiao/1180541.htm . DOI: 10.3760/cma.j.issn.1005-1201.2020.0006 http://dx.doi.org/10.3760/cma.j.issn.1005-1201.2020.0006 ..

管汉雄, 熊颖, 申楠茜, 等.新型冠状病毒肺炎(COVID-19)临床影像学特征[J].放射学实践, 2020, 35(2):125-130.

GUAN H X, XIONG Y, SHEN N Q, et al . Clinical and thin-section CT features of patients with the COVID-19[J ] .Radiol Pract, 2020, 35(2):125-130.

SHI H S, HAN X Y, JIANG N C, et al . Radiological findings from 81 patients with COVID-19 pneumonia in Wuhan, China: a descriptive study[J ] . Lancet Infect Dis, 2020, 20(4): 425-434. DOI:10.1016/s1473-3099(20)30086-4.

[黄璐, 韩瑞, 于朋鑫, 等.新型冠状病毒肺炎不同临床分型间CT和临床表现的相关性研究[J/OL ] .中华放射学杂志, 2020.[Epub ahead of print ] . http://rs.yiigle.com/yufabiao/1180145.htm http://rs.yiigle.com/yufabiao/1180145.htm . DOI: 10.3760/cma.j.issn.1005-1201.2020.0003 http://dx.doi.org/10.3760/cma.j.issn.1005-1201.2020.0003 ..

[HUANG L, HAN R, YU P X, et al . Correlation between CT and clinical manifestations of different clinical types of novel coronavirus pneumonia[J/OL ] . Chin J Radiol, 2020.[Epub ahead of print ] . http://rs.yiigle.com/yufabiao/1180145.htm http://rs.yiigle.com/yufabiao/1180145.htm . DOI: 10.3760/cma.j.issn.1005-1201.2020.0003 http://dx.doi.org/10.3760/cma.j.issn.1005-1201.2020.0003 ..

刘茜, 王荣帅, 屈国强, 等.新型冠状病毒肺炎死亡尸体系统解剖大体观察报告[J].法医学杂志, 2020, 36(1):1-3.

LIU Q, WANG R S, QU G Q, et al . General anatomy report of novel coronavirus pneumonia death corpse[J ] . J Forensic Med, 2020, 36(1):1-3.

HUANG C L, WANG Y M, LI X W, et al . Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China[J ] . Lancet, 2020, 395(10223): 497-506. DOI:10.1016/S0140-6736(20)30183-5.

CHANNAPPANAVAR R, PERLMAN S. Pathogenic human coronavirus infections: causes and consequences of cytokine storm and immunopathology[J]. Semin Immunopathol, 2017, 39(5): 529-539. DOI:10.1007/s00281-017-0629-x.

周红, 李小丽, 李斌.重视2019冠状病毒病(COVID-19)诱导的脓毒症免疫抑制[J].第三军医大学学报, 2020, 42(6):539-544. DOI:10.16016/j.1000-5404.202002172.

ZHOU H, LI X L, LI B. Pay attention to 2019 coronavirus disease (COVID-19) induced sepsis immunosuppression[J]. J Third Mil Med Univ, 2020, 42(6):539-544. DOI:10.16016/j.1000-5404.202002172.

浏览量

下载量

CSCD

文章被引用时，请邮件提醒。

提交

工具集

关联资源

基于胸部CT图像的肺炎深度学习分类预测模型

急性脑梗死患者外周血白细胞水平对意识障碍程度的评估价值

脐血炎性标志物在新生儿肺部感染性疾病中的应用价值

57例非疫区COVID-19出院患者流行病学及临床特点分析

“方舱医院”条件下新型冠状病毒肺炎疑似或轻型患者的高效诊疗流程