不同类型的EBV感染患儿免疫功能与外周血sHLA-G的变化  

Changes of immune function and peripheral blood sHLA-G in children with different types of EBV infection

作　　者：路瑞静 周喜友[1] 江凡[1] 谢小红 周坤朋 王丰[1] LU Ruijing;ZHOU Xiyou;JIANG Fan;XIE Xiaohong;ZHOU Kunpeng;WANG Feng(Department of Clinical Laboratory,Shenzhen Baoan Women′s and Children′s Hospital,Shenzhen,Guangdong 518102,China)

机构地区：[1]广东省深圳市宝安区妇幼保健院检验科,广东深圳518102

出　　处：《检验医学与临床》2020年第19期2795-2797,2801,共4页Laboratory Medicine and Clinic

基　　金：深圳市宝安区科技创新局基金项目(2015094)。

摘　　要：目的分析不同类型的EB病毒(EBV)感染患儿免疫功能与外周血可溶型人类白细胞抗原-G(sHLA-G)的变化。方法选取2017年4月至2018年10月该院收治且确诊的EBV感染患儿132例。根据不同临床类型分为EBV相关淋巴组织细胞增生性噬血综合征(EBV-HLH)组(44例)、慢性活动性EBV感染(CAEBV)组(46例)和传染性单核细胞增多症(IM)组(42例),选取同期体检健康的儿童为对照组(35例)。检测各组的细胞免疫功能[CD3^+、CD4^+、CD8^+T细胞及CD4^+/CD8^+比值]、体液免疫功能[免疫球蛋白(Ig)M、IgG和IgA]和sHLA-G水平。结果与对照组比较,所有EBV感染组的细胞免疫功能均存在异常(P<0.05),IM组CD3^+T细胞水平升高(P<0.05),CAEBV组和EBV-HLH组CD3^+T细胞水平降低(P<0.05)。EBV-HLH组CD4^+T细胞水平最低(P<0.05),IM组CD8^+T细胞水平最高(P<0.05),EBV-HLH组CD4^+/CD8^+最低(P<0.05)。与对照组比较,所有EBV感染组的体液免疫功能均存在异常(P<0.05),EBV-HLH组IgA和IgG水平最低(P<0.05),IgM水平最高(P<0.05)。与对照组比较,所有EBV感染组sHLA-G水平均明显升高,IM组sHLA-G水平最低(P<0.05)。结论不同类型的EBV感染均与免疫功能紊乱相关,sHLA-G水平均明显升高,IM类型的EBV感染患儿较为特殊,T淋巴细胞处于激活状态,体液免疫功能变化较小,sHLA-G水平升高,但升高有限,检测细胞免疫功能、体液免疫功能及sHLA-G水平可鉴别IM类型的EBV感染。Objective To analyze the changes in immune function and peripheral blood soluble human leukocyte antigen-G(sHLA-G)in children infected with different types of Epstein-Barr virus(EBV).Methods A total of 132 children with EBV infection who were admitted to our hospital from April 2017 to October 2018 were enrolled.According to different clinical types,all patients were divided into 4 groups,EBV-associated hemophagocytic lymphohistiocysis(EBV-HLH)group(44 cases),chronic active EBV infection(CAEBV)group(46 cases)and infectious mononucleosis(IM)group(42 cases),healthy children who took the same physical examination at the same time were collected as the control group(35 cases).Cellular immune function[CD3^+,CD4^+,CD8^+T cell and CD4^+/CD8^+ratio],humoral immune function[immunoglobulin(Ig)M,IgG and IgA]and sHLA-G level were measured in all subjects.Results Compared with the control group,the cellular immune function of all EBV-infected groups were abnormal(P<0.05),the CD3^+T cell level of the IM group had increased(P<0.05),and the CD3^+T cell level of the CAEBV group and the EBV-HLH group had decreased(P<0.05),CD4^+T cell level was the lowest in EBV-HLH group(P<0.05),CD8^+T cell level was the highest in IM group(P<0.05),and CD4^+/CD8^+was lowest in EBV-HLH group(P<0.05).Compared with the control group,the humoral immune function of all EBV infection groups were abnormal(P<0.05),the IgA and IgG levels of the EBV-HLH group were the lowest(P<0.05),and the IgM level was the highest(P<0.05).Compared with the control group,sHLA-G level had significantly increased in all EBV infection groups,and IM group sHLA-G level was the lowest(P<0.05).Conclusion Different types of EBV infection are associated with immune dysfunction,sHLA-G level has significantly increased.IM type EBV infection is more special,T lymphocytes are activated,humoral immune fuction nearly normal,sHLA-G level has increased limited,and detection of cellular immune,humoral immune fuction and sHLA-G level can identify the IM-type EBV infection.

关 键 词：EB病毒 细胞免疫功能 体液免疫功能 可溶型人类白细胞抗原-G 

分 类 号：R72[医药卫生—儿科]