中文摘要：

通过动态观察肾综合征出血热患者不同临床阶段NK细胞及CD8＋T细胞表面活化性／抑制性受体等分子的变化，探讨患者抗汉坦病毒感染的免疫机制，为本病的抗感染免疫治疗提供科学依据。收集肾综合征出血热患者血液样本57份，以健康人血做对照，用流式细胞仪检测各组样本NK细胞数及NK细胞亚群、NK细胞活化及抑制受体、CD8＋T细胞数及其表面NK受体的表达水平。分析患者的发热期、少尿期、多尿期和恢复期上述观察指标的动态变化。结果显示，肾综合征出血热患者的NK细胞水平明显高于正常对照组（P〈0．001）。患者的发热期、少尿期、多尿期和恢复期4个不同临床过程中NK细胞水平都处于升高状态，其中少尿期高于其他各期（P〈0．01）。患者NK细胞抑制受体NKG2A表达总水平有下降趋势，在少尿期下降的比较明显（P〈0．01），NK细胞活化受体NKG2D表达呈上升的趋势，不同病程中表达总体水平基本一致。患者的NK细胞亚群cD56-CD16＋和CD56＋。CDl6＋数量显著高于正常对照组（P〈0．01），而cD56dim CDl6＋细胞NK亚群变化无统计学差异（P〉0．05）。患者CD8＋T细胞总数及病程各期均显著高于对照组（P〈0．01）；病例组和对照组CD8＋T细胞表达NK活化受体NKG2D和抑制受体NKG2A无显著差异（P〉0．05）。结果表明，肾综合征出血热患者的急性期NK细胞处于活化状态；其中CD56briCDl6＋NK细胞亚群及CD56-CDl6＋NK细胞在免疫调节方面发挥了重要的作用。

英文摘要：

The changes of natural killer （NK） cells and CD8 ＋ T cells and other factors in hemorrhagic fever patients with renal syndrome （HFRS） in different clinical stages were observed to investigate the immune mechanism of the pa- tients in resisting Hantan virus infection in order to provide scientific foundation for immunological treatment in resis- ting the disease. Fifty seven cases of peripheral blood sample of patients diagnosed with HFRS and peripheral blood of healthy people as the control were collected, and determined the expression level of NK cells and NK cells subgroup, activation or inhibition receptors of NK cells, expressions of, subgroups of NK cells, CD8 ＋ T cells and their surface NK receptors of every group using flow cytometry. And analyzed the dynamic changes of the above mentioned observed indices of the natients in fever staue, oliguria staue_ diuresis stae and recoverv staue. The results showed that the Icy-el of NK cells of HFRS patients was obviously higher than that of normal control group （P 〈 0. 001 ）. The levels of NK cells of patients in fever stage, oliguria stage, diuresis stage and recovery stage were all in a higher state, and the lev- el of NK cells in oliguria stage was higher than the other four stages （P 〈 0.0.1 ）. The general expression level of the patients＇ inhibitory receptor NKG2A of NK cells had a declining trend, and the declining was fairly obvious in oliguria stage （P 〈0.01）. However, the expression of patients＇ activated receptor NKG2D of NK cells had an increasing trend, but the general expressions level of activated receptor NKG2D of NK ceils in four different stages were basically accorded with the general level of the expression in different courses of the disease. The number of subgroup of NK cells, patients＇ both CD56- , CD16 ＋ and CD56CD16-/＋ were significantly higher than that of the normal control group （P 〈 O. O1 ）, while there was no statistical difference in the number of CD56d＋＋CD16 ＋ cells NK subgroup vari