covid - 19后综合征患者的细胞介导免疫

N. Asfandiyarova, V. Demikhov, E. Yakovleva, E. Akimova
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摘要

目的:研究新冠肺炎后综合征的细胞免疫机制。材料与方法:对278例轻、中、重度新冠肺炎急性期合并后综合征患者进行检测。所有的病人都接受了询问,如果有必要,还由不同专业的医生进行检查。根据急性期病程的严重程度和covid后症状表现的持续时间(最长12周或更长)将患者分为2组。采用外周血淋巴细胞对PHA的细胞转化反应(形态学评价反应的方法)来评价细胞介导的免疫状态。同时测定了细胞合成环氧合酶的活性。对照组包括200名几乎健康的同性和年龄相同的人,他们没有接种疫苗,也没有感染冠状病毒。结果:新冠肺炎患者淋巴细胞对PHA的增殖活性降低,轻度(51,4±1.1%,p<0.01)和重度(43,3±1.2%,p< 0.001),重度在急性期后3个月内更为明显(p< 0.001)。在所有组中,合成环氧合酶的细胞活性都有所增加,这会导致炎症,这在患有严重形式的Covid-19的患者中更为明显。结论:冠状病毒感染者外周血淋巴细胞增殖活性在12周内及12周以上均有所降低;这在患有严重形式的Covid-19的患者中尤为明显。在所有组中,细胞合成环氧合酶活性的增加,在炎症的发展中起作用,并可能决定病程的进展。
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Cell-mediated immunity in patients with post-CoVID syndrome
Aim: to study the investigate of the cell-mediate immunity in post-COVID syndrome. Material and Methods: 278 patients with mild, moderate or severe Covid-19 in acute period with post-COVID syndrome were examined. All patients were questioned, and, if necessary, were examined by doctors of various specialties. The patients were divided into 2 groups depending on the severity of the course of the disease in the acute period and the duration of manifestations of post-COVID symptoms (up to 12 weeks or more). The state of cell-mediated immunity was assessed using the reaction of blast transformation of peripheral blood lymphocytes (morphological method for evaluating the reaction) in response to PHA. The activity of cells synthesizing cyclooxygenase was also determined. The control group included 200 practically healthy people of the same sex and age, who were not vaccinated and did not have a coronavirus infection. Results: a decrease in the proliferative activity of lymphocytes in response to PHA was found in patients who underwent Covid-19, both in mild (51,4±1.1%, p<0.01) and severe (49,3± 1,2% p<0,001), more pronounced in the latter in the first three months after the acute period of the disease (p<0,001). In all groups, there is an increase in the activity of cells synthesizing cyclooxygenase, which causes inflammation, which is more pronounced in patients who have had a severe form of Covid-19. Conclusion: The proliferative activity of peripheral blood lymphocytes in people who have had a coronavirus infection is reduced, both in the period up to 12 weeks and beyond; this is especially pronounced in patients who have had severe forms of Covid-19. In all groups, an increase in the activity of cells synthesizing cyclooxygenase, which plays a role in the development of inflammation, and possibly determines the progression of the course, was noted.
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