小儿喉乳头状瘤HPV感染与免疫功能变化的关系研究  

Correlation Between HPV Infection and Immune Function Changes in Children with Laryngeal Papilloma

作　　者：郭正平 张红 GUO Zhengping;ZHANG Hong(Department of Pediatrics,the First People's Hospital of Wuxue,Wuxue Hubei 435499,China)

机构地区：[1]武穴市第一人民医院儿科,湖北武穴435499 [2]武穴市第一人民医院肿瘤科,湖北武穴435499

出　　处：《华南国防医学杂志》2020年第1期37-40,共4页Military Medical Journal of South China

摘　　要：目的探讨初发喉乳头状瘤(laryngeal papilloma,LP)患儿人乳头状瘤病毒(human papillomavirus,HPV)感染状况及免疫功能变化,为疾病的临床治疗提供指导。方法选取2017-10/2019-03月作者医院收治的初发LP患儿40例(LP组),采用实时荧光定量聚合酶链反应(quantitative real-time polymerase chain reaction,qPCR)法进行HPV-DNA检测及分型,并行外周血免疫球蛋白、T淋巴细胞亚群及细胞因子水平测定。另选取同期健康儿童40例为对照组,对两组患儿相关指标进行统计分析。结果 40例LP患儿,HPV11 25例,HPV6 15例,HPV病毒载量与发病时间呈负相关(r=-0.354,P<0.05)。两组患儿血清IgG、IgA、IgM、IgE水平比较无统计学差异(P>0.05)。LP组CD3^+、CD4^+、CD4^+/CD8^+水平均明显低于对照组(P<0.05),两组CD8^+水平比较无统计学差异(P>0.05);不同亚型HPV感染患儿T淋巴细胞亚群水平比较无统计学差异(P>0.05)。LP组白细胞介素4(interleukin-4,IL-4)、IL-6、干扰素-γ(interferon-γ, IFN-γ)、肿瘤坏死因子α(tumor necrosis factorα,TNF-α)水平均明显增高(P<0.05),IFN-γ/IL-4比值明显增大(P<0.05)。结论 LP患儿HPV感染类型包括HPV6、HPV11型,以HPV11为主;HPV感染可引起免疫状态改变,表现为细胞免疫抑制,细胞因子表达增高,以辅助性T细胞1(T helper cell 1, Th1)类为主。Objective To explore the status of human papillomavirus(HPV) infection and changes of immune function in children with primary laryngeal papilloma(LP), and provide guidance for the clinical treatment.Methods Forty children patients with primary LP(LP group) admitted to author’s hospital from October 2017 to March 2019 were selected. The HPV-DNA detection and typing were performed by quantitative real-time polymerase chain reaction(qPCR), and the levels of peripheral blood immunoglobulin,T lymphocyte subsets and cytokine were determined. Another 40 healthy children in the same period were selected as control group, and the related indicators of the two groups were statistically analyzed.Results Among the LP children,the type of HPV11 were 25 cases and HPV6 were 15 cases, and the HPV viral load was negatively correlated with the onset time(r=-0.354, P<0.05).There were no significant differences in the levels of serum IgG, IgA, IgM and IgE between two groups(P>0.05).The levels of CD3^+, CD4^+ and CD4^+/CD8^+ in LP group were significantly lower than those in control group(P<0.05), and no significant difference was found in CD8^+ level between two groups(P>0.05).No significant differences were found in the levels of T lymphocyte subsets in children patients with different subtypes of HPV infection(P>0.05). Compared with control group, the levels of interleukin-4(IL-4), IL-6, interferon-γ(IFN-γ) and tumor necrosis factor α(TNF-α) in LP group were significantly increased(P<0.05), and the ratio of IFN-γ/IL-4 was significantly increased(P<0.05).Conclusion The types of HPV infection in children patients with LP include HPV6 and HPV11, mainly in HPV11. HPV infection can cause changes in immune status, including cellular immunosuppression and increase the cytokine expression,mainly in T helper cell 1(Th1).

关 键 词：小儿 喉乳头状瘤 人乳头状瘤病毒 免疫功能 

分 类 号：R729[医药卫生—儿科]