风疹病毒先天性感染与新生儿临床表现及T淋巴细胞亚群变化的相关性  

Relationships of clinical characters and change in T lymphocyte subsets in neonates with congenital rubella virus infection

作　　者：高冬梅 李秀义[1,2] 蔡瑜 江蓓蕾[1,2] 赵俊 温和[1,2] 

机构地区：[1]安徽医科大学第三附属医院 [2]合肥市第一人民医院检验科,合肥市230061 [3]安徽医科大学微生物学教研室

出　　处：《中华实验和临床感染病杂志（电子版）》2013年第6期40-43,共4页Chinese Journal of Experimental and Clinical Infectious Diseases(Electronic Edition)

基　　金：国家自然科学基金(No.81101273);合肥市医学重点学科建设计划(No.2010-170);安徽医科大学校科研基金(No.0113017201)

摘　　要：目的探讨风疹病毒(RV)先天性感染与出生婴儿临床表现及脐带血T淋巴细胞亚群变化的相关性研究。方法 2009年3月至2010年5月合肥市某医院收集536例新生儿脐带血标本,应用酶联免疫吸附试验(ELISA)检测血清抗-RV-IgM,采用流式细胞术检测抗-RV-IgM阳性脐带血中T淋巴细胞亚群,并追踪新生儿的临床表现。结果新生儿抗-RV-IgM阳性者共有14例,感染率为2.6%,其中有5例患儿出生时出现不同程度的较为典型的临床表现。抗-RV-IgM阳性组与正常对照新生儿组相比:CD3+T淋巴细胞含量降低(P=0.011)、CD4+T淋巴细胞含量降低(P=0.003)、CD8+T淋巴细胞含量较高(P=0.001)、CD4+/CD8+值较低(P=0.005)。其中,抗-RV-IgM阳性有典型的临床表现组CD3+和CD8+T淋巴细胞含量较抗-RV-IgM阳性无典型的临床表现组无显著性差异,而CD4+T淋巴细胞含量降低(P=0.035)、CD4+/CD8+值降低(P=0.008)。结论风疹病毒感染可导致新生儿细胞免疫功能紊乱,而T淋巴细胞亚群变化与新生儿临床表现密切相关。Objective To investigate the relationships of clinical characters and change in T lymphocyte subsets in neonates with congenital rubella virus infection. Methods Total of 536 umbilical cord blood samples were collected in a hospital of Hefei City, Anhui Province during March 2009 to May 2010. Anti-RV-IgM antibodies （anti-RV-IgM） in the sera were detected by enzyme-linked immunosorbent assay （ELISA）. T lymphocyte cell subsets were detected by flow cytometry in the cord blood, and the clinical manifestations of neonates were observed. Results Fourteen （2.6%） cases showed anti-RV-IgM positive. Five cases had obvious and typical clinical manifestations in the neonates with anti-RV-IgM positive. The lower percentage rate of CD3＋ T lymphocyte cells, CD4＋ T lymphocyte cells and higher rate of CD8＋T lymphocyte cells were significantly difference in those with suspected congenital infection than in the normal group （P = 0.011, 0.003 and 0.001）. The ratio of CD4＋/CD8＋ was lower in the neonates with suspected congenital infection than in the normal （P = 0.005）. In the group of positive anti-RV-IgM with clinical signs and symptoms, the low of both CD4＋ T lymphocyte cell and ratio of CD4＋/CD8＋ were seen compared to the neonates with positive anti-RV-IgM without typical clinical manifestations （P = 0.035 and 0.008）. Conclusions Rubella virus infection could lead to neonate’s disorder of cellular immunity. T lymphocyte cell subsets and the clinical manifestations are closely associated.

关 键 词：风疹病毒 T淋巴细胞亚群 临床表现 

分 类 号：R722.1[医药卫生—儿科]