Changes of Subgroups of Peripheral Blood T Lymphocytes in Patients with Severe Pneumonia of Influenza A (H1N1) and its Clinical Significance
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1. Yishan Zheng, 2. Wei Zhao, 3. Yongxiang Yi, 4. Li Zhang
Objective: The main clinical characteristics of the novel swine-origin influenza A (H1N1) include fever, dry cough, normal or lower leukocyte, single or both lung infiltrating. However, less attention has been paid on progressive index about severe pneumonia of H1N1.We aimed to investigate the changes of subgroups of peripheral blood T lymphocytes in patients with the (H1N1) and its clinical significance.
Design: Comparative cohort study between acute phase of patients with severe H1N1 and patients with common H1N1, with normal subjects as controls.
Setting: Second Affiliated Hospital of Southeast University, Nanjing, China.
Patients: All the 208 patients whom clinically diagnosed with H1N1 were hospitalized in the Second Affiliated Hospital of Southeast University from May 2, 2009 to December 20, 2009.
Intervention: Subgroups of blood T lymphocytes in 184 patients with H1N1 were detected by flow cytometer. The results detected in 15 normal subjects were treated as normal control.
Measurements and Main Results The numbers of CD3+, CD4+, and CD8+ lymphocytes all decreased significantly in patients with severe H1N1 at acute phase (605.54±414.68)/μL, (317.91±232.69)/μL, (239.24±160.41)/μL) respectively compared with that of the normal control (1361.60±240.89)/μL, (729.20±163.91)/μL, (497.77±857)/μL, all P<0.01. Moreover, the patients with common H1N1 had CD3+, CD4+ CD8+ decreased (1063.42±532．63)/μL, (553.58±274.31)/μL,(407.29±229.66)/μL respectively. The counts of CD3+, CD4+, and CD8+ lymphocytes decreased more obviously in severe H1N1 patients accompanied with acute respiratory failure. The five patients had CD4+ counts less than 200/μL were in need of ventilation. And the CD3+, CD4+, and CD8+ counts gradually returned to normal when patients’ condition improved.
Conclusions The damage of cellular immunity is probably an important mechanism of H1N1pathogenesis .The significantdecrease of early lymphocytes indicates severe pneumonia or acute respiratory failure.
Measurements and Main Results The numbers of CD3+, CD4+, and CD8+ lymphocytes all decreased significantly in patients with severe H1N1 at acute phase (605.54±414.68)/μL, (317.91±232.69)/μL, (239.24±160.41)/μL) respectively compared with that of the normal control (1361.60±240.89)/μL, (729.20±163.91)/μL, (497.77±857)/μL, all P<0.01. Moreover, the patients with common H1N1 had CD3+, CD4+ CD8+ decreased (1063.42±532．63)/μL, (553.58±274.31)/μL,(407.29±229.66)/μL respectively. The counts of CD3+, CD4+, and CD8+ lymphocytes decreased more obviously in severe H1N1 patients accompanied with acute respiratory failure. The five patients had CD4+ counts less than 200/μL were in need of ventilation. And the CD3+, CD4+, and CD8+ counts gradually returned to normal when patients’ condition improved.
Conclusions The damage of cellular immunity is probably an important mechanism of H1N1pathogenesis .The significantdecrease of early lymphocytes indicates severe pneumonia or acute respiratory failure.
