呼吸道病毒感染患儿外周血淋巴细胞亚群测定及临床意义  

Detection of peripheral blood lymphocyte subsets in children with different respiratory virus infection and its clinical significance

作　　者：冯志山[1] 赵梦川 李贵霞[3] 石仲仁[1] 王乐[1] 袁晔[1] 郭巍巍[1] 李军[1] 杨硕[1] 严小桐[1] 马学军[4] 

机构地区：[1]河北省儿童医院儿研所,石家庄050031 [2]河北医科大学 [3]河北省儿童医院检验科 [4]中国疾病预防控制中心病毒病预防控制所中心实验室

出　　处：《中华实验和临床病毒学杂志》2015年第6期524-527,共4页Chinese Journal of Experimental and Clinical Virology

基　　金：河北省科技支撑计划课题（15277705D）;传染病重大专项（2013ZX10004-001,2012ZX10004-215,2013ZX10004-002和2013ZX10004804-007）

摘　　要：目的分析呼吸道合胞病毒（humanrespiratorysyncytialvirus，HRSV）、副流感病毒3型（humanparainfluenza virus Ⅲ，HPIV3）和鼻病毒（humanrhinovirus，HRV）感染患儿外周血T淋巴细胞亚群、B淋巴细胞及NK细胞的变化，并探讨其临床意义。方法病例对照研究。收集2014年2月-2014年11月河北省儿童医院146例急性呼吸道感染患儿标本，应用GeXP多重基因表达系统及RT—PCR扩增技术检测20种常见呼吸道病毒，选择呼吸道合胞病毒感染50例，副流感病毒III型感染46例，鼻病毒感染50例。50名健康儿童作为对照组。采用流式细胞仪检测病毒感染患儿及健康对照组儿童外周血T淋巴细胞亚群、B淋巴细胞和NK细胞值。病毒感染组与正常对照组的比较采用两独立样本比较的Mann-WhitneyU检验，不同病毒感染组间的比较采用多个独立样本比较的Kruskal-WallisH检验。结果HRSV组、HPIV3组和HRV组患儿外周血CD3＋、CD8＋、CD3＋CD4＋CD8＋、CD56＋水平均明显低于健康对照组（PI均分别为〈0．001，〈0．001，〈0．001，和0．002；P2分别为〈0．001，〈0．001，0．002和0．043；P3分别为〈0．001，〈0．001，0．001和〈0．001），CDl9＋水平及CD4＋／CD8＋比值较对照组均显著升高（P1为0．004和〈0．001；P2、P3均〈0．001）。HRSV组和HPIV3组患儿的外周血CD4＋水平较对照组明显升高（P分别为〈0．001和0．001），但HRV组患儿外周血CD4＋水平与对照组相比，差异无统计学意义（P=0．319）；三组病毒感染组分别比较，HRSV组和HRV组CD4＋水平（P=0．034）和CD4＋／CD8＋比值（P=0．018）差异有统计学意义，其他均无统计学意义。结论HRSV、HPIV3及HRV感染均可导致机体细胞免疫功能明显紊乱，且三种病毒感染后外周血淋巴细胞亚群变化趋势一致，均可使病情恶化或病程延长。及时准确的了解病毒感染患儿外周血淋巴细胞亚群的变化能更好�Objective To analyze the changes of T lymphocyte subsets, B lymphoeytes and NK cells in children with respiratory syneytial virus, parainfluenza 3 and rhinovirus infections and its clinical significance. Methods A total of 146 inpatient children admitted to Children＇ s Hospital of Hebei Province from Feb. 2014 to Nov, 2014 were recruited. The sputum samples were collected and the viral DNA and RNA were extracted. A GeXP-based muhiple RT-PCR kit was used to screen 20 common respiratory viruses. T lymphocyte subsets, B lymphocyte and NK cells in peripheral blood were examined by flow cytometer in 146 patients（50 children were infected with HRSV,48 children were infected with HPIV3 and 50 children were infected with HRV） and 50 healthy subjects as a control group. The levels of all indicators in virus infection group and normal control group were compared by independenttwo-sample Mann-Whitney U test; the levels of all indicators in different virus infection groups were compared using independent Kruskal Wallis test. Results The levels of CD3 ＋ , CD8＋ ,CD3 ＋ CD4 ＋ CD8＋and CD56＋ in the HRSV group （P1 〈 0.001, 〈 0.001, 〈0. 001,and 0.002,respectively） , HPIV3 group （P2 〈0.001, 〈0.001,0.002 and 0. 043 ,respectively） and HRV （P3 〈 0. 001, 〈 0. 001, 0. 001 and 〈 0. 001, respectively） group were significantly lower than those of healthy control group;the levels of CD19＋ and CD4 ＋ / CD8＋in the HRSV group （P1 = 0. 004 and 〈 0. 001 ）, HPIV3 （ P2 〈 0. 001 ） and HRV （ P3 〈 0. 001 ） group were significantly higher than those of the control group. Compared with control group, the peripheral blood CD4＋ levels in HRSV and I-IPIV3 groups were significantly higher（P 〈 0. 001 and 0. 001 ） , however,that of the HRV group hadno statistically significant difference （ P =0. 319 ）. The levels of peripheral blood lymphocyte subsets between HRSV, HPIV3 and HRV groups were compared respectively, the difference of CD4＋ level （P = 0. 034） and CD4＋/CD8＋ ra

关 键 词：呼吸道感染 GeXP多重基因表达系统 淋巴细胞亚群 流式细胞仪 

分 类 号：R725.6[医药卫生—儿科]