过敏性紫癜并支原体感染患儿细胞免疫功能的研究  

A study of cellular immune function of henoch-schonlein purpura combined with mycoplasma infection in children

作　　者：马莲美[1] 贾秀红[1] 王宝宏[1] 吴福玲[1] 张鑫雨[1] 杨华琴[1] 傅振荣[1] 

机构地区：[1]滨州医学院附属医院儿科,山东滨州256600

出　　处：《中华临床医师杂志（电子版）》2011年第11期3179-3184,共6页Chinese Journal of Clinicians(Electronic Edition)

基　　金：滨州医学院科技计划项目(BY2007KJ26)

摘　　要：目的通过流式细胞术检测过敏性紫癜(HSP)合并肺炎支原体(MP)感染患儿外周血CD3+、CD4+、CD8+、CD4+/CD8+、CD19+及自然杀伤细胞(NK)(CD16++CD56+)细胞水平的变化,了解HSP合并MP感染患儿细胞免疫功能状态,探讨MP感染与HSP免疫学发病机制之间的相关性。方法选择53例HSP患儿为研究对象,检测MP-IgM抗体,又分为MP-IgM阳性组21例、阴性组32例,并选择20名健康查体儿童为对照组,通过流式细胞仪(FCM)检测所有儿童外周血CD3+、CD4+、CD8+、CD19+、CD4+/CD8+和NK(CD16++CD56+)细胞水平。结果 53例HSP患儿中MP-IgM阳性21例,其阳性率高达39.6%;HSP患儿外周血CD3+细胞百分率与对照组比较无明显变化,CD4+细胞和NK(CD16++CD56+)细胞百分率均明显降低,与对照组比较有统计学差异(P<0.01);CD4+/CD8+比值下降(P<0.05),与对照组比较差异有统计学意义;本研究结果还显示,HSP患儿CD8+细胞百分率升高(P<0.05),CD19+B细胞显著升高(P<0.01),与对照组比较有统计学差异;HSP患儿支原体感染阳性组与阴性组比较发现,支原体感染阳性组CD8+细胞百分率较阴性组升高,有统计学差异(P<0.05),CD4+/CD8+比值和NK(CD16++CD56+)细胞活性下降更显著,与阴性组比较差异有统计学意义(P<0.05)。结论在HSP儿童中有较高肺炎支原体感染率;HSP患儿存在T细胞功能紊乱,NK细胞活性降低,B细胞多克隆活化,说明细胞免疫功能紊乱参与HSP的发病;伴肺炎支原体感染的HSP患儿细胞免疫功能更加紊乱,表现在CD8+细胞百分率升高更明显,NK(CD16++CD56+)细胞百分率和CD4+/CD8+比值下降更显著;提示MP感染可能在HSP发生、发展中具有重要作用。Objective To explore the cellular immune function and the changes of CD3+,CD4+,CD8++,CD4+/CD8+,CD19+,and the NK cells activity in children with henoch-schonlein purpura (HSP) combined with mycoplasma (MP) infection and investigate the correlation between the MP-infection and HSP.Methods 53 children with HSP children were choosed and divided into two groups (21 cases with MP-IgM positive group,and 32 cases with MP-IgM negative group).And 20 cases were selected as the control group in the same period.The activity of NK cells and CD3+,CD4+,CD8+,CD4+/CD8+,CD19+ were detected by flow cytometry(FCM).Results (1)There were 21 children combined with MP infection in 53 children with HSP,and its infection rate was 39.6%.(2)There was significant difference of CD4+,CD4+/CD8+,NK(CD16++CD56+)cell in HSP group and control group.There was no significanly difference in the peripheral blood.The percentage of CD8+ and CD19+ in HSP group were higher than that of control group(P<0.01).There was no significant difference of CD3+ in two groups.(3)The percentage of CD8+ cells in MP-IgM positive group was higher that of MP-IgM negative group(P<0.05),and the CD4+/CD8+,NK(CD16++CD56+) cells in MP-IgM positive group was lower than that of MP-IgM negative group(P<0.05).Conclusions The infection rate of MP is higher in children with HSP.The abnormal change of cellular immune function exists in children with HSP.It indicates that cellular immunodeficiency may participate in the pathogenesis of HSP.Percentage of CD8+ cells increased and percentage of NK(CD16++CD56+)cells and CD4+/CD8+ ratio decreased in HSP-MP infection group.It indicates MP infection maybe play an important role in the pathogenesis of HSP.

关 键 词：紫癜 过敏性 支原体 肺炎 T淋巴细胞亚群 流式细胞术 儿童 

分 类 号：R725.5[医药卫生—儿科]