腺病毒与呼吸道合胞病毒肺炎患儿外周血淋巴细胞亚群差异分析  

Study on Lymphocyte Subpopulations Differences in Children with ADV Pneumonia and RSV Pneumonia

作　　者：付笑迎[1] 秦慧 郎家庆[1] 杨方华[1] 马东礼[1] 陈运生[1] FU Xiao-ying;QIN Hui;LANG Jia-qing;YANG Fang-hua;MA Dong-li;CHEN Yun-sheng(Department of Laboratory Medicine,Shenzhen Children＇ s Hospital,Guang dong Shenzhen 518038,China;Bengbu Medical College,Anhui Bengbu 233003,China)

机构地区：[1]深圳市儿童医院检验科,广东深圳518038 [2]蚌埠医学院,安徽蚌埠233003

出　　处：《现代检验医学杂志》2018年第4期87-89,94,共4页Journal of Modern Laboratory Medicine

基　　金：深圳市科技创新委员会自由探索项目(JCYJ20160429175623274);广东省医学科学技术研究基金项目(201711515315444)

摘　　要：目的比较腺病毒(adeno virus,ADV)与呼吸道合胞病毒(respiratory syncytial virus,RSV)肺炎患儿及健康儿童外周血淋巴细胞亚群的百分比例并探讨其临床意义。方法收集2014年1月~2015年12月期间在深圳市儿童医院住院的腺病毒肺炎患儿(ADV组)30例,呼吸道合胞病毒肺炎患儿(RSV组)30例(入选依据:60例病毒感染患儿肺部听诊均可闻及中小湿啰音,肺部X线片有点状或片状阴影,临床诊断为肺炎,直接免疫荧光法检测相关病毒抗原结果为阳性且无其他病原感染的临床及实验室证据)以及健康体检儿童(健康组)35例,应用流式细胞术检测上述研究对象外周血中CD3^+T细胞,CD3^+CD4^+T细胞,CD3^+CD8^+T细胞,CD3^-CD56^+NK细胞及CD3^-CD19^+B细胞的百分比并比较各组间的差异。结果与健康组相比较,ADV组[(55.04±8.45)%vs(69.07±9.30)%,t=3.32,P=0.002]与RSV组[(60.90±11.12)%vs(69.07±9.30)%,t=2.43,P=0.004]的CD3^+T细胞比例均下降,差异具有统计学意义(P<0.01),特别是ADV组[(21.26±6.16)%vs(26.97±7.63)%,t=1.87,P=0.04]与RSV组[(21.56±7.06)%vs(26.97±7.63)%,t=1.68,P=0.04]的CD3^+CD8^+T细胞比例明显下降,差异具有统计学意义(P<0.05);与此同时,与健康组相比,ADV组[(28.22±5.16)%vs(17.06±6.42)%,t=3.25,P=0.001]和RSV组[(29.14±10.96)%vs(17.06±6.42)%,t=2.79,P=0.009]的CD3^-CD9^+B细胞比例升高,差异具有统计学意义(P<0.05)。与健康组[(13.54±5.95)%,t=2.01,P=0.03]及ADV组[(16.26±8.34)%,t=2.89,P=0.005]相比,RSV组的CD3^-CD56^+NK细胞亚群比例[(9.59±5.54)%]下降,差异具有统计学意义(P<0.05)。结论腺病毒肺炎和呼吸道合胞病毒肺炎患儿外周血淋巴细胞亚群比例存在统计学差异,病毒性肺炎患儿体内可能存在免疫应答紊乱。Objective To compare the percentage of lymphocyte subsets in children with adenovirus（ADV）pneumonia and respiratory syncytial virus（RSV）pneumonia and healthy children,and explore its clinical significance.Methods Research objective obtained from January 2014 to December 2015 from Shenzhen Children＇s Hospital inpatients diagnosed as ADV pneumonia 30 cases and RSV pneumonia 30 cases（inclusion criteria：60 cases of viral infections in children with lung auscultation could be heard in small and medium wet rales,lung X-ray film a bit like or patchy shadow,clinical diagnosis of pneumonia,direct immunofluorescence assay associated viral antigens were positive and clinical and laboratory evidence of no other pathogens）and 35 cases of healthy check-up children as control group.The percentage of lymphocyte subsets including CD3＋T cells,CD3＋CD4＋T cells,CD3＋CD8＋T cells,CD3-CD19＋B cells and CD3-CD56＋NK cells were detected by flow cytometry.Results Compared with control group,the expression of CD3＋T cells was significantly decreased in ADV group[（55.04±8.45）% vs（69.07±9.30）%,t=3.32,P=0.002]and RSV group[（60.90±11.12）% vs（69.07±9.30）%,t=2.43,P=0.004],especially the expression of CD3＋CD8＋T cells was significantly decreased in ADV group [（21.26±6.16）% vs（26.97±7.63）%,t=1.87,P=0.04]and RSV group [（21.56±7.06）% vs（26.97±7.63）%,t=1.68,P=0.04].Meanwhile,the proportion of CD3-CD19＋B cellsin both ADV [（28.22±5.16）% vs（17.06±6.42）%,t=3.25,P=0.001]and RSV groups [（29.14±10.96）% vs（17.06±6.42）%,t=2.79,P=0.009]were significantly increased.More important,the percentage of CD3-CD56＋NK cells in RSV group [（9.59±5.54）%]was markedly lower compared with ADV group[（16.26±8.34）%,t=2.89,P=0.005]and control group [（13.54±5.95）%,t=2.01,P=0.03].Conclusion Significant percentage of lymphocyte subsets difference was detected among ADV group,RSV group and healthy control group.There may exist immune response disorder with children of RSV or A

关 键 词：儿童 腺病毒肺炎 呼吸道合胞病毒肺炎 淋巴细胞亚群 

分 类 号：R373[医药卫生—病原生物学] R392.11[医药卫生—基础医学]