摘要
目的:探索噬血细胞综合征(HLH)患者中EB病毒(EBV)感染患者的免疫功能状态。方法:回顾性分析北京协和医院急诊科2015-01-2019-12期间明确诊断为HLH患者的临床资料和相关免疫学指标。将血EBV-DNA>500 copies/mL定义为EBV感染阳性。使用SPSS 19.0软件,比较EBV阳性和EBV阴性HLH患者的免疫学差异,并分析EBV-DNA滴度水平和免疫指标是否有相关性。结果:EBV阳性HLH患者较EBV阴性HLH患者病死率明显增高。在免疫学方面,EBV阳性HLH患者补体C4更高,CD3^+T细胞计数显著减低,CD8^+T细胞计数显著减低,CD4/CD8比值显著升高。相关性分析发现,补体C4和EBV-DNA滴度水平呈正相关(R=0.418,P=0.000),CD8^+T细胞水平和EBV-DNA滴度水平呈负相关关系(R=-0.359,P=0.002);CD4/CD8水平和EBV-DNA滴度水平呈正相关关系(R=0.402,P=0.000)。结论:EBV感染的HLH患者预后较差,有明显减低的CD3^+T细胞和CD8^+T细胞计数以及更高的补体C4,且补体C4和CD8^+T细胞计数都与EBV-DNA滴度显著相关。
Objective:To explore the clinical characteristics of EBV infection in patients with hemophagocytic syndrome and to evaluate the immune function of such patients.Method:The clinical data and immunological results of patients with hemophagocytic syndrome were analyzed retrospectively from January 2015 to December 2019.Blood EBV-DNA>500 copies/mL was defined as positive for EBV infection.SPSS 19.0 software was used to compare the difference of immunology between EBV infected patients and non EBV infected patients,and to compare whether EBV-DNA level is related to clinical parameters.Result:Compared with EBV negative hemophagocytic syndrome patients,The EBV positive hemophagocytic syndrome patients had higher mortality.The complement C4 in EBV positive hemophagocytic syndrome patients was higher,the CD3^+T cell count was significantly lower,the CD8^+T cell count was significantly lower,the ratio of CD4/CD8 increased significantly.Correlation analysis showed that there was a negative correlation between CD8^+T cell level and EBV-DNA level(r=-0.359,P=0.002),a positive correlation between CD4/CD8 level and EBV-DNA level(r=0.402,P=0.000),and a positive correlation between complement C4 and EBV-DNA level(r=0.418,P=0.000).Conclusion:EBV positive hemophagocytic syndrome patients had worse clinical outcome compared with EBV negative patients.Their number of CD3^+T cells,CD8^+T cells were significantly decreased and their complement C4 level was higher.Both CD8^+T cells and complement C4 were significantly correlated with EBV-DNA level.
作者
张潇然
刘业成
刘继海
朱华栋
于学忠
ZHANG Xiaoran;LIU Yecheng;LIU Jihai;ZHU Huadong;YU Xuezhong(Departmentof Emergency,Beijing Friend Hospital,Capital Medical University,Beijing,100050,China;Departmentof Emergency Medicine,Peking Union Medical College Hospital,Chinese Academy of Medical Sciences)
出处
《临床急诊杂志》
CAS
2020年第6期437-441,共5页
Journal of Clinical Emergency
关键词
噬血细胞综合征
EB病毒感染
免疫功能状态
hemophagocytic lymphohistiocytosis
EB virus infection
immune function status
