哮喘急性发作患儿合并呼吸道病毒感染的临床特征及辅助性T细胞亚群分析  

Clinical characteristics and helper T cell subgroups in acute exacerbation of asthma children complicated with respiratory virus infections

作　　者：卢可斌 朱万英 王迪彬[1] 鲍丽丽 宋玉佩 LU Ke-bin;ZHU Wan-ying;WANG Di-bin;BAO Li-li;SONG Yu-pei(Shanxian County Central Hospital,Heze,Shandong 274300,China)

机构地区：[1]山东省菏泽市单县中心医院儿科

出　　处：《中华医院感染学杂志》2019年第16期2520-2524,共5页Chinese Journal of Nosocomiology

基　　金：山东省医药卫生科技发展计划基金资助项目(2013WS0098)

摘　　要：目的分析哮喘急性发作患儿合并呼吸道病毒感染的临床特征及辅助性T细胞(helper T cells,Th细胞)细胞亚群,为哮喘患儿继发性感染的预防和控制工作提供研究依据。方法选取2016年3月-2018年3月山东省菏泽市单县中心医院收治的115例支气管哮喘急性发作期患儿作为研究对象,对患儿鼻咽部分泌物中的呼吸道病毒抗原进行检测;对合并呼吸道病毒感染患儿和未合并呼吸道病毒感染患儿的年龄、性别、哮喘病程、发作程度、发作季节、合并肺部感染情况进行观察和比较;对患儿的外周血淋巴细胞百分比、嗜酸性粒细胞百分比、免疫球蛋白E水平及Th1/Th2细胞亚群指标进行检测和分析;对患儿的一秒用力呼气容积(forced expiratory volume in one second,FEV1)、用力肺活量(forced vital capacity,FVC)、动脉血氧分压(partial pressure of oxygen,PaO2)、二氧化碳分压(partial pressure of carbon dioxide, PaCO2)进行检测和分析。结果有78例患儿的鼻咽部分泌物呼吸道病毒抗原检测呈阳性,感染率为67.83%;与未合并呼吸道病毒感染的哮喘急性发作患儿相比较,合并呼吸道病毒感染患儿的年龄较小、哮喘病程较长、外周血淋巴细胞百分比较高且重度发作、春季或冬季、合并肺部感染的比例较高(P<0.05);合并呼吸道病毒感染的哮喘急性发作患儿的外周血Th1细胞比例及Th1/Th2细胞比值,均低于未合并呼吸道病毒感染患儿,Th2细胞比例高于未合并呼吸道病毒感染患儿(P<0.05);合并呼吸道病毒感染的哮喘急性发作患儿的动脉血PaO2水平低于未合并呼吸道病毒感染患儿(P<0.05)。结论哮喘急性发作患儿中呼吸道病毒感染率较高,病原体以呼吸道合胞病毒、副流感病毒、流感病毒为主,合并感染的患儿机体内Th1/Th2细胞亚群失衡更加严重,Th2细胞优势更加明显,这可能是呼吸道病毒感染促进哮喘病情加重和发作的机制之一。OBJECTIVE The clinical characteristics and helper T cell(Th cell) subgroups in acute exacerbation of asthma children complicated with respiratory virus infections, so as to provide the basis for the prevention and control of secondary infection in children with asthma. METHODS Totally 115 cases of children with acute exacerbation of bronchial asthma treated in Shanxian County Central Hospital from Mar. 2016 to Mar. 2018 were selected as the research subjects. The respiratory virus antigens in the nasopharyngeal secretions were detected. The age, the gender, the course of the asthma, the degree of exacerbation, the season of exacerbation, the complication of pulmonary infection were analyzed and compared between the children with and without respiratory virus infections. The percentage of peripheral blood lymphocytes, the percentage of eosinophils, the level of immunoglobulin E and the indicators of Th1/Th2 cell subgroups of the children were detected and analyzed. The forced expiratory volume in one second(FEV1), the forced vital capacity(FVC) and the partial pressure of oxygen(PaO2) and the partial pressure of carbon dioxide(PaCO2) in the arterial blood of the children were measured and analyzed. RESULTS The respiratory tract virus antigens were detected in the nasopharyngeal secretions of 78 cases, and the infection rate was 67.83%. Compared with the children with acute exacerbation of asthma without respiratory virus infections, the children with acute exacerbation of asthma complicated with respiratory virus infections were younger and had longer course of asthma, higher percentage of lymphocyte in peripheral blood as well as higher proportions of severe exacerbation, exacerbation in spring or winter, and complication of pulmonary infections, and the differences were significant(P<0.05). The percentage of Th1 cells and the ratio of Th1/Th2 cells in the peripheral blood of the children with acute exacerbation of respiratory virus infections were lower than those of the children without respiratory virus infect

关 键 词：呼吸道病毒感染 哮喘 急性发作 临床特征 辅助性T细胞 

分 类 号：R562.25[医药卫生—呼吸系统]