不同严重程度的病毒性脑炎患儿T淋巴细胞亚群水平比较  

Comparison of T Lymphocyte Subsets of Children with Different Degrees of Viral Encephalitis

作　　者：屈晓[1] 于春梅[1] 杨春[1] 田广燕[1] Q U Xiao YU Chun- mei YANG Chun T(Department of Neurology, Qilu Children＇ s Hospital of Shandong University, Jinan 250022, Chin)

机构地区：[1]山东大学齐鲁儿童医院神经内科,济南250022

出　　处：《医学综述》2017年第1期145-148,共4页Medical Recapitulate

摘　　要：目的研究不同严重程度的病毒性脑炎患儿T淋巴细胞亚群水平。方法选择2012年1月至2015年6月山东大学齐鲁儿童医院神经内科收治的病毒性脑炎患儿100例,其中58例轻中症患儿为轻中症组,42例重症患儿为重症组,分别比较急性期和稳定期、轻中症和重症以及预后良好和预后不良患儿外周血CD_3^+、CD_4^+、CD_8^+细胞数量和CD_4^+/CD_8^+细胞的比值。并与60例健康中心体检儿童检验结果进行对照。结果重症组CD_3^+、CD_4^+和CD_4^+/CD_8^+显著低于轻中症组和正常组[(52±5)%比(55±7)%、(65±7)%;(37±6)%比(40±6)%、(52±6)%;(1.01±0.14)比(1.16±0.21)、(1.57±0.24)](P<0.05),而CD_8^+显著高于轻中症组和正常组[(37±4)%比(36±4)%、(33±5)%](P<0.05);轻中症组CD_3^+、CD_4^+和CD_4^+/CD_8^+显著低于正常组(P<0.05),而CD_8^+显著高于正常组(P<0.05)。患儿在稳定期CD_3^+、CD_4^+和CD_4^+/CD_8^+三项指标较急性期显著升高(P<0.05),而CD_8^+细胞数量显著下降(P<0.05);预后良好的患儿急性期CD_3^+、CD_4^+和CD_4^+/CD_8^+显著高于预后不良的患儿[(55±6)%比(50±6)%;(40±5)%比(35±5)%;(1.15±0.21)比(0.91±0.20)](P<0.05),而CD_8^+低于预后差的患儿[(35±4)%比(39±3)%](P<0.05)。结论轻中症和重症病毒性脑炎患儿均可发生细胞免疫紊乱,患儿临床症状越重,紊乱越严重,患儿预后越差。早期关注T细胞亚群水平和调节免疫功能有利于患儿获得更好的预后。Objective To analyze T lymphocyte subsets of children with different degrees of viral encephalitis. Methotis A total of 100 viral encephalitis children diagnosed and treated in Qilu Children＇s Hospital of Shandong University from Jan. 2012 to Jun. 2015 were included in the study and divided into a mild type group of 58 cases and a gravis type group of 42 cases. The amount of CD3＋ , CD4＋ , CD8＋T cells and CD4＋/CD8＋ in peripheral blood were compared in the following situations：acute phase and stationary phase, mild type and gravis type,prognosis mala and prognosis bona. And compared with 60 healthy check-up center children＇s test results. Results The amount of CD3＋ ,CD4＋ and CD4＋/CD8＋ cells of gravis type group were significantly lower than those of the mild group and healthy group [ （ 52 ± 5 ） % vs （ 55± 7 ） %, （ 65±7 ） % ; （37 ±6）% vs （40 ±6）% ,（52 ±6）% ;（1.01 ±0. 14） vs （1.16 ±0. 21） ,（1.57 ±0. 24） ,P〈0.05] ,but the CD8＋ cells were higher than the other two groups [ （37 ± 4） % vs （36± 4） % , （35 ±5 ） % , P 〈 0. 05 ]. The amount of CD3＋ , CD4＋ and CD4＋/CD8＋ at acute phase were significantly higher than those at stationary phase （P 〈 0. 05）, but CD8＋ cell amount was lower（ P 〈 0.05 ）. The amount of CD3＋ , CD4＋ and CD4＋/CD8＋ cells of patients with prognosis bona were significantly higher than those of prognosis mala [ （55± 6） % vs （50± 6） %, （40± 5 ） % vs （35±5 ） %, （ 1.15 ±0. 21 ） vs （0. 91± 0. 20）, P 〈 0. 05 ], and CD8＋ cells were lower[ （ 35±4） % vs （ 39 ± 3 ） % , P 〈 0.05 ]. Conclusion There are some disorders in cell mediated immunity with both mild type and gravis type childhood viral encephalitis. And the more grievous of the disorder and the clinical symptoms, the worse the prognosisis. Paying close attention to T lymphocyte subsets and adjusting the immunologic function early can benefit to the patients with better prognosis.

关 键 词：病毒性脑炎 T细胞亚群 病程 儿童 

分 类 号：R446.62[医药卫生—诊断学]