过敏性紫癜肾炎患儿外周血淋巴细胞的变化特点  

Characteristics of peripheral blood lymphocytes in henoch-sch?nlein purpura children with renal involvement

作　　者：焦宏[1] 张辉[1] 佟月娟[1] 王咏红[1] 王国亮[1] 

机构地区：[1]首都医科大学附属北京儿童医院,北京市儿科研究所免疫研究室,儿科学国家重点学科,教育部儿科重大疾病研究重点实验室,北京100045

出　　处：《中华实验和临床感染病杂志（电子版）》2015年第5期88-91,共4页Chinese Journal of Experimental and Clinical Infectious Diseases(Electronic Edition)

摘　　要：目的基于过敏性紫癜(HSP)与上呼吸道感染的密切联系以及感染对免疫系统尤其是淋巴细胞组成的影响,探讨过敏性紫癜肾炎患儿外周血淋巴细胞亚群的变化特点及临床意义。方法采用流式细胞术检测563例过敏性紫癜患儿外周血T淋巴细胞(CD3+、CD4+、CD8+、CD4/CD8)、B细胞(CD19+)以及NK细胞(CD16+CD56+)的水平,比较过敏性紫癜肾炎与无肾炎表现的过敏性紫癜患儿外周血淋巴细胞亚群的差异。结果与无肾炎HSP患儿比较,肾炎HSP患儿的发病年龄较高,性别差异无统计学意义;CD3+(t=-7.077,P<0.001)、CD4+(t=-3.558,P<0.001)和CD8+(t=-5.326,P<0.001)水平显著升高,但CD4/CD8无显著差异(P>0.05),B细胞水平显著下降(t=7.181,P<0.001),NK细胞水平无显著差异(P>0.05)。结论过敏性紫癜患儿存在外周血T淋巴细胞免疫功能紊乱,T淋巴细胞亚群含量的变化尤其是CD8+淋巴细胞的升高,有助于肾炎和非肾炎HSP的鉴别。深入研究感染对HSP患儿淋巴细胞组成的影响,对HSP的防治可能具有重要的意义。Objective To investigate the characteristics of peripheral blood lymphocytes in pediatric henoch-sch？nlein purpura （HSP） with or without nephritis based on the close relationship between allergic purpura nephritis and upper respiratory tract infection and the impact of infection on the immune system, especially on the lymphocytes, and to provide reference for diagnosis and treatment of HSP children. Methods The amount of peripheral blood lymphocyte subsets in 563 children with HSP were analyzed, retrospectively. The levels of T cell （CD3＋, CD4＋, CD8＋）, B cell （CD19＋） and NK cell （CD16＋CD56＋） in peripheral blood were detected by the flow cytometry. The differences between HSP with and without nephritis were analyzed, comparatively.Results Compared with HSP children without nephritis, HSP nephritis children had older age, signiifcantly increased CD3＋ （t =-7.077,P 〈 0.001）, CD4＋（t =-3.558,P 〈 0.001）, CD8＋ （t =-5.326, P 〈 0.001） T cells and signiifcantly decreased B cells （t= 7.181,P 〈 0.001）. There were no signiifcant difference in CD4/CD8 and NK levels between these two groups.Conclusions Peripheral T cell dysfunction exists in HSP children. The amount of T cell subtypes help to judgment whether or not there is nephritis in HSP children. Further study the impact of infection on peripheral T cell dysfunction in children with HSP will help to prevention and treatment of HSP.

关 键 词：过敏性紫癜肾炎 过敏性紫癜 淋巴细胞 

分 类 号：R726.9[医药卫生—儿科]