手足口病患儿外周血T淋巴细胞亚群在病程中的变化及临床意义  

Studies on the changes and clinical significance of peripheral blood T lymphocyte Subsets in 386 Patients with Hand, Foot and Mouth Disease

作　　者：孙林春[1] 张兰芳[1] 张利[2] 胡正[1] 

机构地区：[1]南京医科大学附属南京儿童医院儿科研究所,210008 [2]江苏省中西医结合医院检验科

出　　处：《中国综合临床》2013年第6期660-663,共4页Clinical Medicine of China

摘　　要：目的 观察386例手足口病（HFMD）患儿外周血T淋巴细胞亚群数量在整个病程中的变化，探讨其临床意义。方法用流式细胞仪对386例手足口病患儿（手足口病组）和78名健康儿童（健康对照组）外周血T淋巴细胞亚群进行检测。386例手足口病患儿按病情轻重程度分，325例为普通型（普通型手足口病组），61例为重症型（重型手足口病组）；按病程的不同阶段分，264例为发病期（发病期手足1：3病组），122例为恢复期（恢复期手足口病组）。统计分析手足V：I病患儿与健康儿童，普通型与重症型手足口病患儿，恢复期与发病期手足口病患儿外周血T淋巴细胞亚群数量的差异。结果手足口病组外周血CD3＋、CD4＋、CD8＋细胞相对计数和CD4＋／CD8＋比值依次为（47．4±10．6）％、（24．0±8．0）％、（23．2±7．4）％和1．0±0．5，与健康对照组各项指标[（68．4±7．5）％、（38．2±6．9）％、（18．8±4．6）％和2．0±0．4]比较差异均有统计学意义（￡值分别为3．16、4．62、2．23、2．51，P均〈0．05）；普通型手足口病组外周血CD3＋、CD4＋、CD8＋细胞相对计数和CD4＋／CD8’比值分别为[（53．0±9．8）％、（26．5±7．9）％、（20．4±7．5）％和1．3-t-0．6，与重型手足口病组各项指标[（42．3±10．9）％、（18．7±4．7）％、（24．2±7．4）％和0．7±0．4]比较差异均有统计学意义（t值分别为2．25、2．47、1．91、2．32，P均〈0．05）；发病期手足口病组外周血CD3＋、CD4＋细胞相对计数和CD4’／CD8’比值分别为（45．3±10．5）％、（21．6±8．4）％和0．9±0．5，与恢复期手足口病组[（54．7±9．9）％、（27．5±9．1）％和1．4±0．6]比较差异均有统计学意义（t值分别为2．41、1．87、2．92，P均〈0．05）。结论手足口病患儿的细胞免疫受损，T淋巴细胞功能处于抑制状态，且抑�Objective To detect the changes of peripheral blood T lymphocyte subsets in patients with hand,foot and mouth disease （HFMD） and investigate its clinical significance. Methods Three hundred and eighty-six patients with HFMD and 78 healthy children were detected the peripheral blood T lymphocyte subsets levels using the flow cytometry （FCM）. The patients were divided into 325 common patients and 61 critically ill patients according to the severity of disease. Among the 386 patients,264 were in infection stage and 122 were in recovery stage Compared the differences of peripheral blood T lymphocyte subsets levels in patients and healthy controls, common patients and critically ill patients, infection patients and recovery patients respectively Results The patients＇ numbers of CD3＋ , CIM ＋, CD8＋ cells and CD4 ＋/CD8 ＋ ratio were （47.4 ± 10. 6） % , （24.0± 8.0 ） % , （ 23.2 ± 7.4 ） % and 1.0± 0. 5 respectively. These parameters were significantly different with those in the control group （（68.4±7.5）% ,（38.2 ±6.9）%, （18.8±4.6）% and 2.0 ±0.4 respectively;t =3.16, 4. 62,2. 23 and 2. 51 respectively, P 〈 0.05 ）. The common patients＇ numbers of CD3＋ , CD ＋ , CD8＋ ceils and CD4＋/CD8 ＋ ratio were （53.0 ±9.8）%,（26.5 ±7.9）%,（20.4±7.5）%and 1.3 ＋0.6,which had significant differences compared with those of the critically ill patients （ （ 42. 3± 10. 9 ） %, （ 18.7 ± 4.7 ） %, （24. 2± 7.4） % and （0.7± 0. 4） respectively; t = 2. 25,2.47,1.91 and 2. 32 respectively, P 〈 0.05 ）. The infection patients＇ CD3＋ , CD4 ＋, cell numbers and CD＋/CD8＋ ratio were （45.3 ± 10. 5 ） %, （ 21.6± 8.4） % and 0. 9 ± 0. 5. These parameters were significantly different with those of the recovery patients （ （ 54. 7± 9.9） % , （ 27. 5 ± 9. 1 ） % and 1.4 ±0. 6 respectively; t = 2.41,1.87 and 2. 92 respectively, P 〈 0. 05 ） Conclusion The cellular immunity of patients with HFMD was impaired The T lymphocyte function

关 键 词：手足口病 儿童 T淋巴细胞亚群 细胞免疫 流式细胞仪 

分 类 号：R725.1[医药卫生—儿科]