不同临床表现的诺如病毒感染患儿免疫功能探析  

Analysis of Immune Function in Patients With Norovirus Infection With Different Clinical Manifestations

作　　者：左娜颖 张远达[1] 董青伟[1] 张思思[1] 宋浩彬 ZUO Naying;ZHANG Yuanda;DONG Qingwei;ZHANG Sisi;SONG Haobing(Digestive System Department,Baoding Children’s Hospital,Baoding Hebei 071000,China;Clinical Laboratory,Baoding Children’s Hospital,Baoding Hebei 071000,China)

机构地区：[1]保定市儿童医院消化内科,河北保定071000 [2]保定市儿童医院检验科,河北保定071000

出　　处：《中国卫生标准管理》2021年第22期5-8,共4页China Health Standard Management

基　　金：保定市科技计划项目(18ZF214)。

摘　　要：目的探讨不同临床表现的诺如病毒感染患儿免疫功能。方法2018年5月—2019年3月共纳入40例诺如病毒感染患儿,其中27例为有症状感染患儿,13例无症状感染患儿。分析患儿的16种血清细胞因子的水平,通过逆转录聚合酶链反应(RT-qPCR)定量测定感染者粪便RNA诺如病毒滴度,并与细胞因子的变化进行比较。结果与无症状组相比,有症状组的IFN-γ、IL-1a、IL-1b、IL-1ra、IL-2、IL-4、IL-6、IL-8、IL-10、TNF-β相对表达水平较高,且差异均有统计学意义(P<0.05)。细胞因子与改良Vesikari评分相关性分析表明总体样本与有症状组相关性分析结果一致,总体样本及有症状组IFN-γ、IL-1b、IL-2、IL-4、IL-6、IL-8、IL-10、TNF-β,IL-1ra与改良Vesikari评分具有显著相关性(P<0.05)。此外有无症状与病毒脱落持续时间及病毒的存活率并无显著关系。结论有症状的个体与无症状的个体相比具有更高的免疫系统激活能力,与病毒负荷量无关。表明了症状可能是由诺如病毒感染免疫介导的。Objective To Explore the immune function of children with norovirus infection with different clinical manifestations.Methods Forty children with norovirus infection were included from May 2018 to March 2019,among whom 27 were symptomatic and 13 were asymptomatic.16 serum cytokines were analyzed,and the fecal RNA norovirus titers of infected patients were quantitatively determined by RT-qPCR,and compared with the changes of cytokines.Results Compared with the asymptomatic group,symptomatic individuals had higher serum cytokine concentrations,with significant differences in IFN-γ,IL-1a,IL-1b,IL-1ra,IL-2,IL-4,IL-6,IL-8,IL-10 and TNF-β(P<0.05).Correlation analysis of cytokines and improved Vesikari scores showed that the overall sample was consistent with the correlation analysis of the symptomatic group,while the asymptomatic group had a lower score of improved Vesikari and no obvious symptoms.Correlation analysis of total samples and symptomatic groups showed that IFN-γ,IL-1b,IL-2,IL-4,IL-6,IL-8,IL-10,TNF-β,IL-1ra were significantly correlated with improved Vesikari scores(P<0.05).Symptoms were not associated significantly with duration of viral shedding or cumulative shedding.Conclusion Symptomatic individuals,compared to asymptomatic,have greater immune system activation,as measured by serum cytokines,but they do not have greater viral burden,as measured bytitre and shedding,suggesting that symptoms may be immune-mediated in NoV infection.

关 键 词：诺如病毒 肠胃炎 细胞因子 症状 病毒RNA滴度 病毒负荷量 免疫激活 

分 类 号：R446[医药卫生—诊断学]