哮喘与感染患儿外周血中性粒细胞CD64指数、B淋巴细胞、BTLA的表达差异及临床意义研究  

The expression differences and the clinical significance of CD64 on neutrophils and BTLA on B lymphocyte in peripheral blood in children between with asthma and with infection

作　　者：唐宗生[1] 许雪梅 秦道建 李志鸿[3] 陶明芬 TANG Zongsheng;XU Xuemei;QIN Daojian;LI Zhihong;TAO Mingfen(Department of Blood Transfusion,Yijishan Hospital,Wannan Medical College,Wuhu,Anhui 241001,China;The Affiliated Shanghai Children＇s Medical Center of Shanghai J iaotong University School of Medicine,Shanghai 200127,China;Department of Pediatrics,Yijishan Hospital,Wannan Medical College,Wuhu,Anhui 241001,China;He,nopuri fication Center,Yijishan Hospital,Wannan Medical College,Wuhu,Anhui 241001,China)

机构地区：[1]皖南医学院弋矶山医院输血科,安徽芜湖241001 [2]上海交通大学医学院附属上海儿童医学中心200127 [3]皖南医学院弋矶山医院儿科,安徽芜湖241001 [4]皖南医学院弋矶山医院血液净化中心,安徽芜湖241001

出　　处：《检验医学与临床》2018年第18期2685-2689,共5页Laboratory Medicine and Clinic

基　　金：安徽省自然科学基金资助项目(1608085MH217)

摘　　要：目的研究哮喘与细菌感染患儿外周血中性粒细胞CD64指数、B淋巴细胞、B和T淋巴细胞衰减因子(BTLA)的表达差异及其作用机制。方法选取皖南医学院弋矶山医院儿科2015年6月至2017年1月收住入院的49例患儿,其中3~6岁哮喘患儿26例(哮喘组),同期一般细菌感染患儿为23例(感染组)。两组受试对象在性别、年龄及体质量上差异均无统计学意义(P>0.05)。住院后24h内收集两组清晨空腹外周静脉血,应用流式细胞术检测外周血中性粒细胞CD64指数和B淋巴细胞水平及其BTLA表达水平,散射比浊法测定血清IgE水平,免疫透射比浊法测定血清CRP水平。结果哮喘组外周血中性粒细胞CD64水平高于感染组(P<0.05)。哮喘组B淋巴细胞百分比高于感染组(P<0.05);哮喘组B淋巴细胞表面BTLA表达较感染组减少(P<0.01);哮喘组B淋巴细胞百分比与其表达BTLA成正相关(r=0.569 8,P<0.01)。哮喘组外周血清CRP水平较感染组低(P<0.05)。哮喘组外周血清IgE水平较感染组显著升高(P<0.01)。结论感染是哮喘的诱发因素之一,CD64、CRP的早期检测可指导哮喘患儿抗菌药物的应用。BTLA在哮喘患儿B淋巴细胞表达下调,参与免疫应答的调控。Objective To study the differential expression of CD64 on neutrophils and BTLA on B lymphocyte in peripheral blood in children with asthma or bacterial infection,which to explore its mechanism and clinical significance.Methods Children from 3 to 6 years old who were hospitalized at the First Affiliated Hospital of Wannan Medical College were selected as the study subjects from June 2015 to January 2017.In asthma group,there were 26 cases was diagnosed according to the eighth edition of Chu Fu Practical Pediatrics of children;and in the general bacterial infection group,there were 23 cases with infection index anomaly.There were little significant discrepancies in weight between the general bacterial infection group and the asthma group（P〈0.05）,also age and gender.There were no other complications in these children.Children with asthma and general bacterial infection were not treated prior to admission.The fasting peripheral venous blood was collected within 24 hours after hospitalization.Flow cytometry was used to test neutrophil CD64 index,the percentage of B lymphocytes and the expression of BTLA on B lymphocytes.IgE was tested by turbidimetry.And CRP was detected by immunoturbidimetry.Results The serum neutrophils CD64 in the asthma group was higher than that in the infection group（P〈0.05）.B lymphocytes percentage in the asthma group was higher than the infection group（P〈0.05）;the expression of BTLA on B lymphocyte in the asthma group was lower than that in the infection group（P〈0.01）;and the correlation between B lymphocyte and its BTLA was positive（r=0.569 8,P〈0.01）.The level of serum CRP in the asthma group was lower than that in the infection group（P〈0.05）.The level of serum IgE in the asthmatic group was significantly higher than that in the infection group（P〈0.01）.Conclusion One of the high risk factors of asthma is bacterial infection.Early detection of CD64 and CRP can guide the application of antibiotics in children with asthma.The expression of BTLA on B lymp

关 键 词：中性粒细胞 CD64 B淋巴细胞 B和T淋巴细胞衰减因子 哮喘 细菌感染 儿童 

分 类 号：R720.5[医药卫生—儿科]