Objective To explore the relationship between peripheral blood lymphocytes and disease progression in patients with amyotrophic lateral sclerosis(ALS)in central China.Methods A total of 133 ALS patients diagnosed at Tongji Hospital,Tongji Medical College,Huazhong University of Science and Technology were evaluated for disease progression,and the includ-ed patients were divided into fast progression group and slow progression group.Peripheral blood lymphocyte subsets were de-termined and compared between the two groups.Logistic regression was used to analyze the association between the statistically different lymphocyte subgroups and the rate of disease progression.Results The proportion of CD3+CD19-T lymphocytes in the slow progression group was lower than that of the fast progression group(P＜0.05).However,the NK cell count,NK cell proportion,and the proportion of CD28+helper T cells(CD28+Th cells)were higher than those of the fast progression group(all P＜0.05).In the logistic regression analysis,an increase in NK cell count(OR=0.992,P＜0.05)and an increase in the propor-tion of CD28+Th cells(OR=0.895,P＜0.05)were protective factors for the progression of ALS.Conclusion The characteris-tics of peripheral lymphocytes differed between patients with slow and fast progression.Abnormalities in the innate immune sys-tem may be involved in the progression of ALS.