川崎病患儿T细胞免疫功能的变化及临床意义  

Changes of T cell immune function and the clinical significance in infants with kawasaki disease

作　　者：游文忠[1] 周发为[2] 卢巧[1] 黄华[1] 

机构地区：[1]湖北民族学院附属民大医院小儿内科,湖北恩施445000 [2]湖北民族学院附属民大医院检验科,湖北恩施445000

出　　处：《川北医学院学报》2016年第6期888-890,共3页Journal of North Sichuan Medical College

摘　　要：目的:观察川崎病(kawasaki disease,KD)患儿体内T淋巴细胞亚群及相关细胞因子的变化,分析其在KD发病中的意义。方法:选取KD患儿55例设为KD组,同期住院的普通发热非KD患儿47例设为非KD组,另选取同期门诊体检的健康儿童40例设为对照组。使用流式细胞仪检测各组儿童外周血CD3+、CD3+CD4+、CD3+CD8+、CD3+CD19+、CD4+/CD8+、CD4+CD25+比例,分析ROC曲线特征。使用ELISA法检测各组儿童血清白介素6(IL-6)、IL-1β及肿瘤坏死因子α(TNF-α)水平。结果:KD急性期患儿组外周血CD3+、CD3+CD8+、CD4+CD25+比例低于非KD组及对照组;CD3+CD4+、CD3+CD19+、CD4+/CD8+比例高于另两组(P<0.01)。KD组患儿血清TNF-α、IL-1β及IL-6水平明显高于非KD组及对照组(P<0.01),非KD组IL-1β及IL-6水平高于对照组(P<0.01)。KD患儿CD3+、CD3+CD4+、CD3+CD8+、CD3+CD19+、CD4+/CD8+、CD4+CD25+ROC曲线对KD的诊断界值分别为54.5%、28.6%、20.4%、26.1%、1.8%、6.0%。结论:KD患儿体内存在T淋巴细胞亚群失衡,表现为CD4+CD25+、CD3+CD8+减少,CD3+CD4+、CD3+CD19+比例及CD4+/CD8+比值升高,且IL-6、TNF-α、IL-1β等细胞因子水平升高,可能参与了KD病理过程。Objective：To observe the changes of T lymphocyte subsets and relative cytokines in infants with kawasaki disease （KD） and to observe their significance in process of KD. nethods：A total of 55 infants with KD were selected as KD group,while 47 infants with non-KD in corresponding period served as non-KD group,and another 40 healthy infants undergoing physical examinations as control group. Flow cytometer （FCM） was used to detect the ratios of peripheral blood CD3 ＋ ,CD3 ＋ CD4 ＋ ,CD3 ＋ CD8 ＋ ,CD3 ＋ CD19 ＋ , CD4 ＋/CD8 ＋ and CD4 ＋ CD25 ＋ in all groups and analyze the curve characters of receiver operating characteristic （ ROC）. Enzyme-linked immuno sorbent assay （ELISA） was applied to detect the levels of serum interleukin 6 （IL-6） , IL-1 β and tumor necro- sis factor-α （TNF-α） in all groups. Results：KD group was evidently lower in the ratios of peripheral blood CD3 ＋ ,CD3 ＋ CD8 ＋ and CD4 ＋CD25 ＋ ,but markedly higher in the ratios of CD3 ＋ CD4 ＋ ,CD3 ＋ CD19 ＋ and CD4 ＋/CD8 ＋ than other two groups （P 〈 0. 01 ）. KD group was notably higher in levels of serum TNF-α, IL-1β and IL-6 than other two groups （P 〈 0. O1 ） , whereas non-KD groups was significantly higher in levels of IL-1β and IL-6 than control group （ P 〈 0. 01 ）. The diagnostic critical values of ROC curves ofCD3 ＋,CD3 ＋CD4＋,CD3 ＋CD8＋,CD3 ＋CD19＋,CD4＋/CD8 ＋ and CD4 ＋CD25 ＋ were 54.5%,28.6%,20.4%,26.1%, 1.8% and 6.0% respectively. Conclusion：Infants with KD have imbalance of T lymphocyte subsets marked by reduced CD4 ＋ CD25 ＋ and CD3 ＋ CD8 ＋ ,increased ratios of CD3 ＋ CD4 ＋ ,CD3 ＋ CD19 ＋ and CD4 ＋/CD8 ＋ as well as levels of IL-6,TNF-α and IL- 1β,which may participate in the pathological process of KD.

关 键 词：川崎病 儿童 T淋巴细胞 细胞因子 免疫功能 诊断界值 

分 类 号：R725.4[医药卫生—儿科]