儿童郎格罕斯细胞组织细胞增生症免疫功能检测意义  

Examination of immune function for children with Langerhans cell histiocytosis and its significance

作　　者：宋爱琴[1] 庞秀英[1] 卢愿[1] 李学荣[1] 赵艳霞[1] 仲任[1] 孙立荣[1] 

机构地区：[1]青岛大学医学院附属医院小儿血液科,山东青岛266003

出　　处：《临床儿科杂志》2009年第8期735-737,共3页Journal of Clinical Pediatrics

摘　　要：目的了解郎格罕斯细胞组织细胞增生症(LCH)患儿治疗前后细胞和体液免疫功能状态。方法将30例LCH患儿按Lavin-Osband法分为3组。采用流式细胞仪检测LCH患儿及26例正常对照组儿童外周血CD3+、CD4+、CD8+、CD3-CD(16+56)+、CD19+含量,采用特定蛋白分析仪检测患儿及正常对照儿童血清IgA、IgM、IgG含量。结果三组LCH患儿确诊时,各组间CD3+、CD19+差异均无统计学意义(P均>0.05),Ⅲ组LCH患儿CD4+/CD8+、CD3-CD(16+56)+低于其他组,差异均有统计学意义(P均<0.05);LCH患儿确诊时各组间血清Ig与正常对照组比较差异均无统计学意义(P均>0.05);Ⅱ组和Ⅲ组LCH患儿治疗6个月时CD4+/CD8+分别低于治疗前,差异均有统计学意义(P均<0.05);LCH患儿治疗前后CD3-CD(16+56)+、CD19+比较,差异均无统计学意义(P均>0.05)。LCH患儿治疗前后血清Ig比较,差异无统计学意义(P>0.05)。结论LCH患儿发病时存在细胞免疫功能降低,与病情轻重有关;体液免疫功能无明显改变。LCH患儿化疗后可出现细胞免疫功能紊乱加重。检测LCH患儿的免疫功能,可为免疫调节治疗提供客观依据。Objective To explore the immune function of pediatric patients with Langerhans cell histioeytosis （LCH） before and after chemotherapy. Methods All the 30 eases of LCH were divided into 3 groups according to Lavin-Oshand method. Levels of CD3^＋, CD4^＋, CD8^＋, CD3^-CD（16 ＋ 56）^＋ and CD19^＋ in peripheral blood by flow cytometry and the serum levels of IgA, IgM, IgG by specific protein analyzer were determined in 30 cases before and after six-month treatment. Twenty-six （26） healthy children in the control group were also tested. Results There was no significant difference in the levels of CD3^＋ and CD19^＋ among the three groups at any time point determined （P 〉 0.05）. But the ratio of CD4^＋/CD8^＋ and CD3-CD（16 ＋ 56）^＋ of group Ⅲ were lower than that of the, group Ⅱ, group Ⅱ and the control group （P 〈 0.05）; Compared with the control group, there was no significant difference in serum immunoglobins at the time of diagnosis （P 〉 0.05） ; the ratio of CD4^＋/CD8^＋ of both group Ⅱ and the group Ⅲ after 6-month treatment were lower than that before treatment （P 〈 0.05）; The levels of CD3^-CD（16 ＋ 56）^＋ and CD19^＋ had no significant difference between before treatment and after treatment （P〉0.05） and neither did the serum immunoglobins （P 〉 0.05）. Conclusions LCH children had abnormal T and NK cell function, which were related to the severity of the illness. Humoral immunological function did not change significantly. After chemotherapy the immune dysfunction became significantly worse. The detection of immunological function in LCH children provided an objective basis for treatment of immune response modifier.

关 键 词：郎格罕斯细胞组织细胞增生症 免疫功能 儿童 

分 类 号：R725.5[医药卫生—儿科]