传染性单核细胞增多症患儿T细胞亚群及其PD-1、Tim-3表达的意义  

Significance of T cell subsets and expression of PD-1 and Tim-3 in children with infectious mononucleosis

作　　者：王卫国[1] 王伟伟[1] 冯玉虎[2] WANG Weiguo;WANG Weiwei;FENG Yuhu(Department of Clinical Laboratory,Fuyang Peoples Hospital,Fuyang,236001,China;Department of Hematology,Fuyang Peoples Hospital)

机构地区：[1]阜阳市人民医院检验科,安徽阜阳236001 [2]阜阳市人民医院血液科

出　　处：《临床血液学杂志》2021年第9期646-649,654,共5页Journal of Clinical Hematology

摘　　要：目的:探讨传染性单核细胞增多症(IM)患儿T细胞亚群及其程序性细胞死亡受体1(PD-1)、T细胞免疫球蛋白及黏蛋白分子3(Tim-3)表达的意义。方法:选择73例IM患儿包括伴肝功能损伤31例(IM A组)、不伴肝功能损伤42例(IM B组)和20例健康对照者,利用流式细胞术检测外周血T细胞亚群的比例、绝对计数以及CD4^(+)T和CD8^(+)T上PD-1、Tim-3表达频率。结果:与对照组比较,IM患儿CD3^(+)T细胞和CD8^(+)T细胞百分比及绝对值增高、CD4^(+)和CD8^(+)T细胞上PD-1、Tim-3表达频率升高(P<0.05),而CD4^(+)T细胞百分比和CD4/CD8比值降低(P<0.05);与IM B组比较,IM A组CD3^(+)T细胞和CD8^(+)T细胞百分比及绝对值升高(P<0.05),而CD4^(+)T细胞百分比和CD4/CD8比值降低(P<0.05)。多因素分析显示,CD8^(+)T细胞百分比升高是肝功能损伤的影响因素[OR=1.072,95%CI(1.003,1.145),P<0.05]。结论:T细胞亚群偏移、CD4^(+)和CD8^(+)T细胞上PD-1和Tim-3表达升高参与IM的发病,而CD8^(+)T细胞百分比增高与肝功能损伤有关。Objective: To explore the significance of T cell subsets and expression of programmed cell death 1(PD-1) and T cell immunoglobulin and mucin domain-containing protein 3(Tim-3) in children with infectious mononucleosis(IM). Methods: The percentage and absolute count of T cell subsets and PD-1 and Tim-3 expression on CD4^(+)T cells and CD8^(+)T cells were measured by flow cytometry in 73 IM children, including 31 cases with liver function injury(IM A group) and 42 cases without liver function injury(IM B group), and 20 healthy controls. Results: Compared with control group, the percentage and absolute counts of CD3^(+)T cells and CD8^(+)T cells, frequencies of PD-1 and Tim-3 on CD4^(+)T cells and CD8^(+)T cells increased(P<0.05), while the percentage of CD4^(+)T cells and CD4/CD8 ratio decreased in children with IM(P<0.05). Compared with IM B group, the percentage and absolute counts of CD3^(+)T cells and CD8^(+)T cells increased(P<0.05), the percentage of CD4^(+)T cells and CD4/CD8 ratio decreased(P<0.05) in IM A group. Multivariate analysis showed the increased percentage of CD8^(+)T was an influential factor for liver function injury(OR=1.072, 95%CI[1.003, 1.145], P<0.05). Conclusion: The T cell subsets skewing and increased expression of PD-1 and Tim-3 on CD4^(+)and CD8^(+)T cells are involved in the pathogenesis of children with IM. The increased percentage of CD8^(+)T cells is associated with liver function injury.

关 键 词：传染性单核细胞增多症 CD8+T细胞 程序性细胞死亡受体1 T细胞免疫球蛋白及黏蛋白分子3 

分 类 号：R512.7[医药卫生—内科学]