武汉地区婴儿肝病综合征病原分析及细胞免疫研究  

Pathogeny and Cellular Immunity Analysis of Infantile Hepatitis Syndrome in Wuhan Area

作　　者：王佳[1] 宋娜[1] 陈莎[1] 邱艳[1] 艾洪武[1] 

机构地区：[1]武汉市妇女儿童医疗保健中心检验部,武汉430016

出　　处：《现代检验医学杂志》2010年第1期102-103,106,共3页Journal of Modern Laboratory Medicine

摘　　要：目的探讨武汉地区婴儿肝病综合征的主要致病因素及相应的细胞免疫特征。方法采用酶联免疫吸附法检测132例肝病综合征患儿血清病毒抗体，测定项目包括乙型肝炎病毒（HBV）、巨细胞病毒（CMV）、EB病毒、单纯疱疹病毒（HSV）以及风疹病毒（RV），同时采用流式细胞仪免疫荧光法检测患儿T淋巴细胞亚群，结果与患儿ALT值进行相关分析。结果病原学检查以巨细胞感染最多见，占26．5％，其次是HSV感染，占1．5％；CMV—IgM（＋）患儿中ALT值异常（ALT〉40U／L）者占91．4％，且其CD4^＋淋巴细胞绝对数升高而百分比降低，CD8^＋淋巴细胞绝对数和百分比均升高，CD3^＋淋巴细胞绝对数升高，CD4^＋／CD8^＋比值显著降低，与同龄健康婴儿及CMV—IgM（-）组比较，均P〈0．05，差异有统计学显著性意义。结论巨细胞病毒是婴儿肝病综合征的重要致病因子，小儿感染CMV肝炎后细胞免疫功能处于相对抑制状态，T淋巴细胞亚群测定可作为判断病情轻重及预后的辅助指标。Objective To investigate the main cause and the immunologic characteristic of infantile hepatitis syndrome in Wuhan area. Methods 132 cases with infant hepatitis syndrome were enrolled in the study. HBV,CMV-IgM,EBV-IgM, HSV-IgM and RV-IgM serum markers were detected by using ELISA method ,and T lymphocyte subsets were analyzed by flow eytometry. Serum ALT were analyzed as well. Results Virus infection,especially cytomegalovirus infection（26.5%） played a key role and secondly, the infections of HSV （1.5%）. In the CMV-IgM （＋） group, the absolute amount of CD3^＋, CD4^＋, CD8^＋ cell and the percent of CD8^＋ cell were higher than those in group CMV-IgM （-） and the healthy control group （P〈0. 05）,but the percent of CD4^＋ cell and the ratio of CD4^＋ to CD8^＋ cell were lower. Conclusion The results sugest that CMV infection is the main cause of infant hepatitis syndrome,and the cellular immunity is relatively decreased in the infection. The changes of T lymphocyte subsets are significantly to clinical therapy and prognosis of children.

关 键 词：婴儿肝病综合征 人巨细胞病毒 T淋巴细胞亚群 流式细胞仪 

分 类 号：R725.7[医药卫生—儿科] R392.12[医药卫生—临床医学]