T淋巴细胞亚群检测在新型冠状病毒肺炎临床应用价值中的研究进展

doi:10.19983/j.issn.2096-8493.20220066

摘要/Abstract

摘要：

新型冠状病毒肺炎作为一种新发病毒感染性疾病,有着极高传染性与致病性,其发病机理过程复杂,人体免疫应答对病毒的抵抗显得十分关键。T淋巴细胞介导的适应性免疫在人体清除病毒中起着重要作用,而免疫功能受损可促使病情迅速进展。作者通过总结并阐述T淋巴细胞亚群在新型冠状病毒肺炎中的变化特点和临床意义,为临床诊疗及判断转归提供依据。

关键词: 新型冠状病毒,肺炎, 免疫, 细胞, T淋巴细胞亚群, 综述文献(主题)

Abstract:

As a new viral infectious disease, COVID-19 has a very high infectivity and pathogenicity. Its pathogenesis is complex, and the human immune response induced resistance to the virus is very critical. T lymphocyte-mediated adaptive immunity plays an important role in virus clearance in the human body, and immune function getting impaired can also promote rapid progression of the disease. Therefore, we summarized and expounded the characteristic of changes of T lymphocyte subsets and the clinical significance of testing them in COVID-19 patients, to provide a basis for clinical diagnosis, treatment and prognostic judgment.

Key words: SARS-CoV-2, pneumonia, Immunity, Cellular, T-Lymphocyte Subsets, Review literature

中图分类号:

R512.99

陈木兴, 范欣欣, 陈晓红, 林友飞, 黄明翔, 陈力舟, 吴迪. T淋巴细胞亚群检测在新型冠状病毒肺炎临床应用价值中的研究进展[J]. 结核与肺部疾病杂志, 2022, 3(4): 343-346. doi: 10.19983/j.issn.2096-8493.20220066

Chen Muxing, Fan Xinxin, Chen Xiaohong, Lin Youfei, Huang Mingxiang, Chen Lizhou, Wu Di. Research progress of the clinical value of applying T lymphocyte subsets examination in COVID-19 patients[J]. Journal of Tuberculosis and Lung Disease, 2022, 3(4): 343-346. doi: 10.19983/j.issn.2096-8493.20220066

参考文献 52

[1]	Velanvan TP, Meyer CG. The COVID-19 epidemic. Trop Med Int Health, 2020, 25(3):278-280. doi: 10.1111/tmi.13383. doi: 10.1111/tmi.13383 URL
[2]	吴迪, 范欣欣, 沈建山, 等. 联合检测凝血筛查指标及D-二聚体对新型冠状病毒肺炎患者临床分型的诊断价值. 结核与肺部疾病杂志, 2021, 12(2):355-360. doi: 10.19983/j.issn.2096-8493.20210133. doi: 10.19983/j.issn.2096-8493.20210133
[3]	蒋奕, 胡腾, 司果, 等. 新型冠状病毒感染者T淋巴细胞亚群的改变及动态观察. 实用医院临床杂志, 2020, 17(4):35-37. doi: 10.3969/j.issn.1672-6170.2020.04.010. doi: 10.3969/j.issn.1672-6170.2020.04.010
[4]	张乐, 刘幸, 张艳, 等. 血常规及T淋巴细胞亚群在新型冠状病毒肺炎病程监测中的意义. 中国中西医结合急救杂志, 2020, 27(5):513-517. doi: 10.3969/j.issn.1008-9691.2020.05.001. doi: 10.3969/j.issn.1008-9691.2020.05.001
[5]	周国忠, 杨明霞, 钱颖. 新型冠状病毒肺炎患者外周血四类淋巴细胞的检测与分析. 浙江医学, 2020, 42(21):2347-2350. doi: 10.12056/j.issn.1006-2785.2020.42.21.2020-1054. doi: 10.12056/j.issn.1006-2785.2020.42.21.2020-1054
[6]	姚小红, 李廷源, 何志承, 等.新型冠状病毒肺炎(COVID-19)三例遗体多部位穿刺组织病理学研究. 中华病理学杂志, 2020, 49(5):411-417. doi: 10.3760/cma.j.cn112151-20200312-00193. doi: 10.3760/cma.j.cn112151-20200312
[7]	Channappanavar R, Fett C, Zhao J C, et al. Virus-specific memory CD8T cells provide substantial protection from lethal severe acute respiratory syndrome corona virus infection. J Virol, 2014, 88(19):11034-11044. doi: 10.1128/JVI.01505-14. doi: 10.1128/JVI.01505-14 pmid: 25056892
[8]	张思也, 侯粲, 钟燕军, 等.脓毒症T淋巴细胞亚群免疫监测的研究进展. 中华重症医学电子杂志, 2021, 7(1):48-54. doi: 10.3877/cma.j.issn.2096-1537.2021.01.009. doi: 10.3877/cma.j.issn.2096-1537.2021.01.009
[9]	Li M, Guo W, Don Y, et al. Elevated exhaustion levels of NK and CD8(+)T cells as indicators for progression and prognosis of COVID-19 disease. Front Immunol, 2020, 11:580237. doi: 10.3389/fimmu.2020.580237. doi: 10.3389/fimmu.2020.580237 URL
[10]	Saris A, Reijnders TDY, Nossent EJ, et al. Distinct cellular immune profiles in the airways and blood of critically ill patients with COVID-19 Thorax, 2021, 76(10):1010-1019. doi: 10.1136/thoraxjnl-2020-216256. doi: 10.1136/thoraxjnl-2020-216256 pmid: 33846275
[11]	吴强, 卢春晓, 肖强, 等. 危重型新型冠状病毒肺炎患者T淋巴细胞亚群分析. 暨南大学学报(自然科学与医学版), 2021, 42(1):80-87,93. doi: 10.11778/j.jdxb.2021.01.011. doi: 10.11778/j.jdxb.2021.01.011
[12]	董艳迎, 李妙羡, 朱建宏, 等. 新型冠状病毒肺炎患者实验室检测指标与免疫学特征分析. 分子诊断与治疗杂志, 2020, 12(6):697-700,714. doi: 10.3969/j.issn.1674-6929.2020.06.003. doi: 10.3969/j.issn.1674-6929.2020.06.003
[13]	Li H, Liu L, Zhang D, et al. SARS-CoV-2 and viral sepsis:observations and hypotheses. Lancet, 2020, 395(10235):1517-1520. doi: 10.1016/S0140-6736(20)30920-X. doi: 10.1016/S0140-6736(20)30920-X URL
[14]	杨晓玲, 徐新民, 宋淑静, 等. T淋巴细胞亚群在新型冠状病毒肺炎患者中的表达及外周血白细胞水平的临床价值研究. 标记免疫分析与临床, 2020, 27(10):1659-1662. doi: 10.11 748/bjmy.issn.1006-1703.2020.10.006. doi: 10.11 748/bjmy.issn.1006-1703.2020.10.006
[15]	史晓朋, 秦历杰, 杨蕾, 等. 白细胞介素-6联合CD4⁺T淋巴细胞检测对评估新型冠状病毒肺炎严重程度及预后的价值. 中华危重病急救医学, 2020, 32(10):1165-1170. doi: 10.3760/cma.j.cn121430-20200521-00395. doi: 10.3760/cma.j.cn121430-20200521
[16]	凌云, 林逸骁, 钱志平, 等. 新型冠状病毒肺炎患者重症化危险因素的临床分析. 中华传染病杂志, 2020, 38(4):193-198. doi: 10.3760/cma.j.cn311365-20200211-00055. doi: 10.3760/cma.j.cn311365-20200211-00055
[17]	Chen NS, Zhou M, Dong X, et al. Epidemiological and clinical characteristics of 99 cases of 2019 novel coronavirus pneumonia in Wuhan,China:a descriptive study. Lancet, 2020, 395(10223):507-513. doi: 10.1016/S0140-6736(20)30211-7. doi: 10.1016/S0140-6736(20)30211-7 URL
[18]	Liu WJ, Zhao M, Liu KF, et al. T-cell immunity of SARS-CoV:Implications for vaccine development against MERS-CoV. Antiv Res, 2017, 137:82-92. doi: 10.1016/j.antiviral.2016.11.006. doi: 10.1016/j.antiviral.2016.11.006 URL
[19]	Yang XB, Yu Y, Xu JQ, et al. Clinical course and outcomes of critically ill patients with SARS-CoV-2 pneumonia in Wuhan,China: a single centered, retrospective, observational study. Lancet Respir Med, 2020, 8(5):475-481. doi: 10.1016/S2213-2600(20)30079-5. doi: 10.1016/S2213-2600(20)30079-5 URL
[20]	Henry BM, Lippi G, Plebani M.Laboratory abnormalities in children with novel coronavirus disease 2019.Clin Chem Lab Med, 2020, 58(7):1135-1138. doi: 10.1515/cclm-2020-0272. doi: 10.1515/cclm-2020-0272
[21]	李泉, 聂珂, 乔正荣, 等. 淋巴细胞亚群在新型冠状病毒肺炎患者外周血中的表达及临床意义. 国际检验医学杂志, 2020, 41(17):2092-2095. doi: 10.3969/j.issn.1673-4130.2020.17.010. doi: 10.3969/j.issn.1673-4130.2020.17.010
[22]	Wu ZY, Mcgoogan JM. Characteristics of and important lessons from the coronavirus disease 2019 (COVID-19) outbreak in China:summary of a report of 72 314 cases from the Chinese Center for Disease Control and Prevention. JAMA,2020, 323(13):1239-1242. doi: 10.1001/jama.2020.2648. doi: 10.1001/jama.2020.2648 URL
[23]	马静静, 伍丹丹, 张吉翔, 等. 新冠肺炎患者外周血T淋巴细胞亚群的变化及意义中华临床医师杂志, 2020(10):759-763. doi: 10.3877/cma.j.issn.1674-0785.2020.10.002. doi: 10.3877/cma.j.issn.1674-0785.2020.10.002
[24]	陈惠丽, 刘曦, 黄珊凤, 等. 新型冠状病毒肺炎患者外周血T淋巴细胞亚群变化中华实验和临床感染病杂志, 2021, 15(2):99-104. doi: 10.3877/cma.j.issn.1674-1358.2021.02.005. doi: 10.3877/cma.j.issn.1674-1358.2021.02.005
[25]	孟现民, 张莉, 董平, 等. CD4⁺T淋巴细胞和CD8⁺T淋巴细胞对新型冠状病毒肺炎的临床分型及其预后的价值中华传染病杂志, 2021, 39(2):65-69. doi: 10.3760/cma.j.cn311365-20200409-00487. doi: 10.3760/cma.j.cn311365-20200409-00487
[26]	朱义朗, 徐元宏, 汪小五, 等. 新型冠状病毒肺炎患者血常规及淋巴细胞亚群的变化特点. 天津医药, 2020, 48(7):596-598. doi: 10.11958/20200588. doi: 10.11958/20200588
[27]	孙峰, 杨建中, 刘雪梅, 等. 新型冠状病毒肺炎患者细胞免疫指标的动态演变及其对核酸转阴时间的影响. 临床肺科杂志, 2021, 26(12):1788-1793. doi: 10.3969/j.issn.1009-6663.2021.12.002. doi: 10.3969/j.issn.1009-6663.2021.12.002
[28]	郭丽蕊, 张艳冰, 杨吉安, 等. 新型冠状病毒肺炎患者实验室检查指标及其预后的危险因素研究. 实用心脑肺血管病杂志, 2021, 29(12):73-79. doi: 10.12114/j.issn.1008-5971.2021.00.267. doi: 10.12114/j.issn.1008-5971.2021.00.267
[29]	杨硕, 苏斌涛, 陈菁, 等. 糖皮质激素对新型冠状病毒肺炎患者T淋巴细胞亚群的影响. 中国呼吸与危重监护杂志, 2021, 20(3):159-163. doi: 10.7507/1671-6205.202004070. doi: 10.7507/1671-6205.202004070
[30]	Wang F, Nie JY, Wang HL, et al. Characteristics of peripheral lymphocyte subset alteration in COVID-19 pneumonia. J Infect Dis, 2020, 221(11):1762-1769. doi: 10.1093/infdis/jiaa150. doi: 10.1093/infdis/jiaa150 pmid: 32227123
[31]	连利霞, 孔存权, 刘鸿雁, 等. 细胞免疫功能指标与新型冠状病毒肺炎患者病情的相关性. 河南医学研究, 2021, 30(10):1729-1732. doi: 10.3969/j.issn.1004-437X.2021.10.001. doi: 10.3969/j.issn.1004-437X.2021.10.001
[32]	Chen R, Sang L, Jiang M, et al. Longitudinal hematologic and Immunologic variations associated with the progression of COVID-19 patients in China. J Allergy Clin Immunol, 2020, 146(1):89-100. doi: 10.1016/j.jaci.2020.05.003. doi: 10.1016/j.jaci.2020.05.003 URL
[33]	Xu Z, Shi L, Wang Y, et al. Pathological findings of COVID-19 associated with acute respiratory distress syndrome. Lancet Respir Med, 2020, 8(4):420-422. doi: 10.1016/S2213-2600(20)30076-X. doi: 10.1016/S2213-2600(20)30076-X URL
[34]	Luo Y, Xie Y, Zhang W, et al. Combination of lymphocyte number and function in evaluating host immunity. Aging (Albany NY), 2019, 11(24):12685-12707. doi: 10.18632/aging.102595. doi: 10.18632/aging.102595
[35]	张益明, 高世定, 王占科, 等. 3例新型冠状病毒肺炎患者外周血CD4⁺T淋巴细胞和CD4⁺/CD8⁺比值变化. 国际检验医学杂志, 2020, 41(17):2173-2176. doi: 10.3969/j.issn.1673-4130.2020.17.030. doi: 10.3969/j.issn.1673-4130.2020.17.030
[36]	Qin C, Zhou L, Hu Z, et al. Dysregulation of Immune Response in Patients With Coronavirus 2019 (COVID-19) in Wuhan, China. Clin Infect Dis, 2020, 71(15):762-768. doi: 10.1093/cid/ciaa248. doi: 10.1093/cid/ciaa248 URL
[37]	许靖, 韩明锋, 赵凤德, 等. 155例新型冠状病毒肺炎患者的临床表现与血清免疫学特点中华医院感染学杂志, 2020, 30(15):2261-2265. doi: 10.11816/cn.ni.2020-200577. doi: 10.11816/cn.ni.2020-200577
[38]	唐莉歆, 石安琪, 万秋, 等. 老年新型冠状病毒肺炎50例临床特征及危险因素分析. 中国感染与化疗杂志, 2021, 21(1):62-66. doi: 10.16718/j.1009-7708.2021.01.011. doi: 10.16718/j.1009-7708.2021.01.011
[39]	Wang W, Xu Y, Gao R, et al. Detection of SARA CoV2 in different types of clinical specimens. JAMA, 2022, 323(18):1843-1844. doi: 10.1001/jama.2020.3786. doi: 10.1001/jama.2020.3786
[40]	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. 第三军医大学学报, 2020, 42(9):872-878. doi: 10.16016/j.1000-5404.202003035. doi: 10.16016/j.1000-5404.202003035
[41]	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. 法医学杂志, 2020, 36(1):1-3. doi: 10.12116/j.issn.1004-5619.2020.01.005. doi: 10.12116/j.issn.1004-5619.2020.01.005
[42]	Li L, Yang L, Gui S, et al. Association of clinical and radiographic fndings with the outcomes of 93 patients with COVID-19 in Wuhan,China. Theranostics, 2020, 10(14):6113-6121. doi: 10.7150/thno.46569. doi: 10.7150/thno.46569 URL
[43]	屈满英, 孙瑞琳, 刘庆峰, 等. 外周血炎症标志物联合T淋巴细胞亚群检测在新型冠状病毒肺炎的临床价值探讨. 中国现代医学杂志, 2020, 30(15):61-64. doi: 10.3969/j.issn.1005-8982.2020.15.011. doi: 10.3969/j.issn.1005-8982.2020.15.011
[44]	Liu J, Li S, Liu J, et al. Longitudinal characteristics of lymphocyte responses and cytokine profiles in the peripheral blood of SARS-CoV2 infected patients. EBioMedicine, 2020, 55:102763. doi: 10.1016/j.ebiom.2020.102763. doi: 10.1016/j.ebiom.2020.102763 URL
[45]	罗高权, 黄文杰, 张一帆, 等. 新型冠状病毒肺炎患者256例入院时白细胞、中性粒细胞及淋巴细胞亚群回顾性分析. 实用医学杂志, 2020, 36(13):1700-1704. doi: 10.3969/j. issn.1006-5725.2020.13.002. doi: 10.3969/j. issn.1006-5725.2020.13.002
[46]	刘波, 单南冰, 雷习群, 等. 新型冠状病毒肺炎患者核酸转阴时间的影响因素及与淋巴细胞亚群的关系. 临床检验杂志, 2021, 39(5):333-336. doi: 10.13602/j.cnki.jcls.2021. 05.03. doi: 10.13602/j.cnki.jcls.2021. 05.03
[47]	Hu XW, Xing YH, Jia J, et al. Factors associated with negative conversion of viral RNA in patients hospitalized wih COVID-19. Sci Total Environ, 2020, 728:138812. doi: 10.1016/j.scitotenv.2020.138812. doi: 10.1016/j.scitotenv.2020.138812 URL
[48]	廖宝林, 施海燕, 刘艳霞, 等. 新型冠状病毒肺炎患者早期外周血淋巴细胞亚群及细胞因子特征. 中华实验和临床感染病杂志, 2021, 12(3):182-188. doi: 10.3877/cma.j.issn.1674-1358.2021.03.007. doi: 10.3877/cma.j.issn.1674-1358.2021.03.007
[49]	Ling Y, Xu SB, Lin YX, et al. Persistence and clearance of viral RNA in 2019 novel coronavirus disease rehabilitation patients. Chin Med J (Engl), 2020, 133(9):1039-1043. doi: 10.1097/CM9.0000000000000774. doi: 10.1097/CM9.0000000000000774
[50]	赵本南, 杜清, 兰丽娟, 等. 新型冠状病毒肺炎核酸复阳者与未复阳者的临床特征比较. 热带医学杂志, 2022, 22(2):212-217. doi: 10.3969/j.issn.1672-3619.2022.02.015. doi: 10.3969/j.issn.1672-3619.2022.02.015
[51]	李泉, 张浩, 邓斯予, 等. 新型冠状病毒肺炎恢复期病毒核酸检测复阳患者与阴性患者外周血淋巴细胞亚群的表达及形态学特征的比较研究. 重庆医学, 2020, 49(19):3151-3155. doi: 10.3969/j.issn.1671-8348.2020.19.002. doi: 10.3969/j.issn.1671-8348.2020.19.002
[52]	Lee CC, Chen SY, Tsai CL, et al. Prognostic value of mortality in emergency department sepsis score,procalcitonin, and C-reactive protein in patients with sepsis at the emergency department. Shock, 2008, 29(3):322-327. doi: 10.1097/shk.0b013e31815077ca. doi: 10.1097/shk.0b013e31815077ca URL