Measurement Of Subsets Of Peripheral Blood TBNK Lymphocyte In Influenza A (H1N1) Patients And Its Clinical Significance

BackgroundInfluenza A H1N1 was a new type of respiratory-borne disease caused by influenza A H1N1 virus. It broke out in Mexico in March 2009 and spread at an alarming rate, showing a large trend. Its global average fatality rate was 1.247percent, significantly higher than the normal seasonal influenza. It could easily convert to severe influenza.PurposeTo accumulate the experiences of the severe and critical patients'clinical treatment, investigate the state of the influenza A H1N1 patients'immunity, and find the potential clinical value of blood TBNK lymphocyte subsets, we retrospectively analysed the patients with the severe and critical influenza A (H1N1) and the changes in peripheral blood TBNK lymphocyte subsets determined by the flow cytometer analysis.MethodWe retrospectively analysed clinical features of the patients with the severe and critical influenza A (H1N1) and determined the peripheral blood TBNK lymphocyte subsets by the flow cytometer analysis in 41 patients and 41 healthy persons.ResultsIn our hospital, 41 severe and critical influenza A (H1N1) patients were between 5 to 75 years old. There were 11 imported cases and 30 local cases. The main routes of transmission were droplet infection by air and close contact. For most of patients, the first appearance of symptom was fever (95.1%), and the common symptoms included cough, pharyngodynia, out of breath, headache, muscle ache all over the body, nasal obstruction and nose running, nausea, diarrhea et al. In the laboratory examination, most of the cases showed normal or low counts of WBC in peripheral blood. some cases had the damages of liver function and myocardial enzymes. Lung CT scanning revealed changes related to pneumonia. In general, the clinical features of the severe and critical influenza A(H1N1) were related to the ordinary pneumonia. The lymphocyte subsets detection revealed that in acute phase the numbers of CD3+, CD4+,CD8+, CD16/56 lymphocytes all significantly decreased in acute phase of the severe and critical influenza A (H1N1) patients compared with those in normal persons (CD3+ P<0.01, CD8+ P<0.01, CD4+ P<0.05, CD16/56 P<0.01). The numbers of CD3+ ,CD4+, CD8+, CD16/56 in the critical influenza A (H1N1) patients were less than the ones of the severe influenza A (H1N1) patients(P<0.01). The numbers of CD3+, CD8+ and CD16/56 in the severe patients were less than the ones of normal people (P<0.01). As the patients'conditions improved ,the counts of CD4+ gradually returned to normal, but the counts of CD3+, CD8+, CD16/56 were still less than the ones of normal persons(P<0.05), the count of CD19+ was higher than the ones of normal persons (P<0.05).Conclusion1. From October 2009 to December 2009, most of the influenza A (H1N1) cases in Hangzhou were local cases.2. The clinical features of the severe and critical influenza A were related to the ordinary pneumonia.3. The patients with severe and critical influenza A (HINI) were found having damage of the cellular immunity markedly.