Decrease of CD4+ T lymphocytes in patients with H1N1 in early stage and its clinical significances

Objective: To observe the change of CD4+ T Lymphocytes in patients with H1N1 at early stage and figure out its clinical significances on the progress and therapeutic selection of H1N1. Methods: The absolute counts of T lymphocyte subset from the peripheral blood samples of 48 H1N1 patients in first ten days' duration were detected by flow cytometry, and the serial chest CT examinations were performed. Results: In all 48 clinical cases, 28 cases were in normal range of CD4+ lymphocyte absolute count, whose pulmonary lesions were limited and illness condition stayed in the stability, they didn't need steroid. In the other 20 cases with low level of CD4+, 4 cases' illness presented the progressive development and needed to be treated with steroid and 16 cases with lightly decreased CD4+ level which had a stable condition without treatment with steroid. The result of Pearson correlation analysis showed that there were negative correlations between absolute count of CD4+ cells and pulmonary lesions (r=-0.299, P<0.05) and steroid treatment (r=-0.383, P<0.05). Conclusion: The lower peripheral blood CD4+ cell absolute count of H1N1 patients at early stage indicates the worse condition of pulmonary lesions. The patients with remarkable decrease of CD4+ lymphocytes are in need of treatment with steroid. (authors)