内科

目的探讨COVID-19患者外周血T淋巴细胞亚群绝对计数的变化情况及其与肺内病变的关系以及胸腺法新治疗对患者病情的影响。方法选取2020年1月22日至2月26日广西柳州市人民医院感染性疾病科收治的COVID-19普通型患者16例（观察组）以及同期在我院进行健康体检的健康者16名（对照组）为研究对象，检测比较COVID-19患者与健康体检者的CD4+T、CD8+T淋巴细胞绝对计数；分析COVID-19患者的CD4+T、CD8+ T淋巴细胞绝对计数与其肺内病变评分的相关性；治疗1周后，比较是否联合使用胸腺法新治疗的COVID-19患者的CD4+T、CD8+T淋巴细胞绝对计数。结果观察组患者（入院时）的CD4+T、CD8+T淋巴细胞绝对计数显著低于健康对照组，差异有统计学意义（P＜0.05）。Spearman相关性分析结果显示，COVID-19患者CD4+T、CD8+T淋巴细胞的绝对计数与其肺内病变评分呈负相关性（r=-0.639，P=0.008；r=-0.569，P=0.021）。使用胸腺法新治疗的患者其CD4+T、CD8+T淋巴细胞绝对计数上升幅度显著大于未使用胸腺法新治疗的患者，差异有统计学意义（P＜0.05）。结论COVID-19患者外周血CD4+ T淋巴细胞绝对计数显著减少，其CD4+T、CD8+T淋巴细胞绝对计数与其肺内病变的严重程度评分呈负相关，联合使用胸腺法新治疗是否有助于患者的病情恢复尚有待进一步观察。

ObjectiveTo explore the changes of peripheral blood T lymphocyte subsets absolute counts in patients with COVID-19 and their relationship with lung lesions, and the influence of thymalfasin on the condition of patients. MethodsA total of 16 common COVID-19 patients (observation group) admitted to Liuzhou People′s Hospital in Guangxi from 22nd January to 26th February 2020, and 16 healthy people (control group) who were accepted physical examination during the same period were selected as the research objects. The absolute counts of CD4+ T and CD8+ T lymphocytes of COVID-19 patients and healthy people were tested and compared. The correlation between the absolute counts of CD4+ T and CD8+ T lymphocytes of COVID-19 patients and their lung lesions scores were analyzed. After 1 week of treatment, the absolute counts of CD4+ T and CD8+ T lymphocytes in COVID-19 patients with or without the combination of thymalfasin were compared. ResultsThe absolute counts of CD4+ T and CD8+ T lymphocytes in the observation group (at admission) were significantly lower than those in the control group, and the differences were statistically significant (P＜0.05). The Spearman correlation analysis results showed that the absolute counts of CD4+ T and CD8+ T lymphocytes in COVID-19 patients were negatively correlated with their lung lesions scores (r=-0.639, P=0.008; r=-0.569, P=0.021 ). The increase of absolute counts in CD4+ T and CD8+ T lymphocyte of patients treated with thymalfasin was significantly greater than those of patients treated without thymalfasin, and the difference was statistically significant (P＜0.05). ConclusionThe absolute counts of CD4+ T lymphocytes in the peripheral blood of COVID-19 patients significantly decrease, whereas the absolute counts of CD4+ T and CD8+ T lymphocytes are negatively correlated with the severity of the lung lesions. It remains to be seen whether the combination of thymalfasin will help recovery in patients.