肺炎支原体肺炎患儿外周血CD4^(-)CD8^(-)双阴性T淋巴细胞变化的意义  

Significance of changes in CD4^(-)CD8^(-)double negative T lymphocytes in peripheral blood of children with Mycoplasma pneumoniae pneumonia

作　　者：窦寅菡 夏敏[2] 周华 张薇[1] 车大钿[1] Dou Yinhan;Xia Min;Zhou Hua;Zhang Wei;Che Datian(International Clinic Center,Shanghai Children′s Hospital,Children′s Hospital of Shanghai Jiaotong University,Shanghai 200062,China;Department of Laboratory,Shanghai Children′s Hospital,Children′s Hospital of Shanghai Jiaotong University,Shanghai 200062,China)

机构地区：[1]上海市儿童医院,上海交通大学附属儿童医院特诊部,200062 [2]上海市儿童医院,上海交通大学附属儿童医院检验科,200062

出　　处：《中华实用儿科临床杂志》2021年第16期1226-1229,共4页Chinese Journal of Applied Clinical Pediatrics

摘　　要：目的探讨肺炎支原体肺炎(MPP)患儿外周血CD4^(-)CD8^(-)双阴性T淋巴细胞(DNT)、T淋巴细胞亚群、自然杀伤(NK)细胞、CD_(19)^(+)B淋巴细胞的变化及临床意义。方法回顾性分析2019年1月至2020年2月上海交通大学附属儿童医院收治的肺炎患儿,年龄段划分为0~3岁、4~7岁、≥8岁,急性期接受外周血T淋巴细胞亚群检测,其中185例MPP患儿为观察组,根据病情分为117例MPP普通组和68例MPP重症组,另外选取69例非MPP肺炎患儿作为对照组。采用流式细胞术分析各组患儿外周血DNT、T淋巴细胞亚群、NK细胞、CD_(19)^(+)B淋巴细胞绝对计数。分析不同年龄段DNT水平。结果1.观察组外周血淋巴细胞CD3+[1.527(1.059,2.348)×10^(9)/L]、CD4^(+)[0.771(0.559,1.206)×10^(9)/L]、CD8^(+)[0.528(0.343,0.773)×10^(9)/L]、CD4^(+)/CD8^(+)[1.570(1.130,1.945)]、CD_(19)^(+)[0.455(0.285,0.771)×10^(9)/L]、DNT[0.168(0.095,0.294)×10^(9)/L]均低于对照组[2.116(1.506,3.728)×10^(9)/L、1.170(0.685,2.114)×10^(9)/L、0.696(0.414,1.226)×10^(9)/L、1.780(1.230,2.210)、0.694(0.483,1.343)×10^(9)/L、0.235(0.134,0.391)×10^(9)/L],差异均有统计学意义(均P<0.05)。2.MPP普通组的外周血淋巴细胞CD3+[1.704(1.215,2.566)×10^(9)/L]、CD4^(+)[0.855(0.628,1.267)×10^(9)/L]、CD8^(+)[0.582(0.378,0.843)×10^(9)/L]、NK[0.269(0.176,0.417)×10^(9)/L]、CD_(19)^(+)[0.461(0.317,0.808)×10^(9)/L]、DNT[0.180(0.117,0.306)×10^(9)/L]均明显高于MPP重症组[1.369(0.831,1.760)×10^(9)/L、0.676(0.433,0.924)×10^(9)/L、0.495(0.292,0.699)×10^(9)/L、0.196(0.112,0.380)×10^(9)/L、0.391(0.181,0.730)×10^(9)/L、0.143(0.071,0.265)×10^(9)/L],差异均有统计学意义(均P<0.05)。3.急性期,观察组外周血DNT与相同年龄段对照组比较差异均无统计学意义(均P>0.05);观察组中,0~3岁组外周血DNT[0.230(0.125,0.364)×10^(9)/L]高于4~7岁组[0.143(0.085,0.233)×10^(9)/L]和≥8岁组[0.144(0.078,0.271)×10^(9)/L],且在0~3岁组病情越重,指标越低,差异均有统计学意义Objective To discuss the changes and clinical significance of CD4^(-)CD8^(-)double negative T lymphocytes(DNT),T lymphocyte subsets,natural killer(NK)cells and CD_(19)^(+)B lymphocytes in peripheral blood of children with confirmed Mycoplasma pneumoniae pneumonia(MPP).Methods A retrospective analysis was conducted on children with pneumonia admitted to the Children′s Hospital of Shanghai Jiaotong University from January 2019 to February 2020.The patients were stratified into 3 age groups:0-3 years old,4^(-)7 years old and≥8 years old,and they received detection of peripheral blood T lymphocyte subsets in acute stage.As observation group,185 MPP children were further divided into MPP common group(117 cases)and MPP severe group(68 cases)based on their state of pneumonia.In addition,69 cases with non-MPP were selected as control group.The absolute counts of DNT,T lymphocyte subsets,NK cells and CD_(19)^(+)B lymphocytes in peripheral blood were tested by flow cytometry.DNT levels in diffe-rent age groups were analyzed.Results(1)The number of CD3+[1.527(1.059,2.348)×10^(9)/L],CD4+[0.771(0.559,1.206)×10^(9)/L],CD8^(+)[0.528(0.343,0.773)×10^(9)/L],CD4+/CD8^(+)[1.570(1.130,1.945)],CD_(19)^(+)[0.455(0.285,0.771)×10^(9)/L]and DNT[0.168(0.095,0.294)×10^(9)/L]lymphocytes in peripheral blood in the observation group were lower than those in the control group[2.116(1.506,3.728)×10^(9)/L,1.170(0.685,2.114)×10^(9)/L,0.696(0.414,1.226)×10^(9)/L,1.780(1.230,2.210),0.694(0.483,1.343)×10^(9)/L,0.235(0.134,0.391)×10^(9)/L],and the differences were statistically significant(all P<0.05).(2)In addition,the number of CD3+[1.704(1.215,2.566)×10^(9)/L],CD4+[0.855(0.628,1.267)×10^(9)/L],CD8^(+)[0.582(0.378,0.843)×10^(9)/L],NK[0.269(0.176,0.417)×10^(9)/L],CD_(19)^(+)[0.461(0.317,0.808)×10^(9)/L]and DNT[0.180(0.117,0.306)×10^(9)/L]lymphocytes in peripheral blood in MPP common group were significantly higher than those in MPP severe group[1.369(0.831,1.760)×10^(9)/L,0.676(0.433,0.924)×10^(9)/L,0.495(0.292,0.699)×10^(9)/L

关 键 词：肺炎支原体肺炎 儿童 CD4-CD8-双阴性T淋巴细胞 T淋巴细胞亚群 

分 类 号：R725.6[医药卫生—儿科]