干扰素α-1b联合人免疫球蛋白对EB病毒感染患儿临床疗效及对Ficolin-3、SH2D1A表达的影响  

Clinical effect of interferonα-1b combined with human immunoglobulin on the expression of Ficolin-3 and SH2D1A in children infected with EB virus

作　　者：宋昆泽 李雅莉 牟建 SONG Kunze;LI Yali;MOU Jian(Department of Paediatrics,3201 Hospital,Hanzhong,Shaanxi 723000,China;Microbiological Immunologic Laboratory,3201 Hospital,Hanzhong,Shaanxi 723000,China)

机构地区：[1]三二〇一医院儿科,陕西汉中723000 [2]三二〇一医院微生物及免疫科,陕西汉中723000

出　　处：《国际检验医学杂志》2022年第16期1930-1934,共5页International Journal of Laboratory Medicine

基　　金：陕西省自然科学基础研究计划(2018JM-394)。

摘　　要：目的探讨人干扰素α-1b联合人免疫球蛋白治疗对EB病毒(EBV)感染患儿的临床疗效,并分析治疗对患儿免疫相关分子纤维胶凝蛋白3(Ficolin-3)、SH2结构域蛋白1A(SH2D1A)表达水平的影响。方法选取2018年2月至2020年2月在该院就诊的130例EBV感染患儿,根据治疗方式不同分为对照组和观察组,各65例。对照组给予常规治疗,观察组在常规治疗基础上给予人干扰素α-1b联合人免疫球蛋白治疗。观察两组发热、咳嗽、颈淋巴结肿大、咽痛、扁桃体肿大和肝脾肿大各项临床症状的消失时间。采用荧光定量PCR(RT-qPCR)检测治疗前后两组EBV-DNA、EBV-CA-IgM及EBV-NA-IgG,采用酶联免疫吸附试验(ELISA)检测两组治疗前后血清Ficolin-3、SH2D1A水平,以及外周血白细胞介素(IL)-6、IL-8、肿瘤坏死因子(TNF)-α水平,采用流式细胞术分析T淋巴细胞亚群CD3^(+)、CD4^(+)、CD8^(+)及CD4^(+)/CD8^(+)。结果观察组发热、咳嗽、颈淋巴结肿大、咽痛、扁桃体肿大和肝脾肿大各项临床症状的消失或消退时间均短于对照组,EBV-DNA、EBV-CA-IgM转阴率均高于对照组,差异均有统计学意义(P<0.05)。与治疗前比较,治疗后两组Ficolin-3、SH2D1A、IL-6、IL-8、TNF-α、CD8^(+)明显降低,CD3^(+)、CD4^(+)及CD4^(+)/CD8^(+)明显升高,差异均有统计学意义(P<0.05)。治疗前Ficolin-3、SH2D1A表达与IL-6、IL-8、TNF-α及CD8^(+)呈正相关(r=0.478、0.454、0.503,0.462、0.443、0.511,均P<0.001),与CD3^(+)、CD4^(+)及CD4^(+)/CD8^(+)呈负相关(r=-0.567、-0.402、-0.423,-0.477、-0.416、-0.409,均P<0.001)。观察组治疗总有效率[96.92%(63/65)]明显高于对照组[80.00%(52/65)],差异有统计学意义(χ^(2)=9.119,P=0.003),并发症总发生率[9.23%(6/65)]明显低于对照组[30.77%(20/65)],差异有统计学意义(χ^(2)=9.423,P=0.002)。结论干扰素α-1b联合人免疫球蛋白能降低EBV感染患儿Ficolin-3、SH2D1A水平,改善患儿免疫功能,提高治疗有效性。Objective To investigate the clinical efficacy of human interferonα-1b combined with human immunoglobulin in the treatment of children with EB virus(EBV)infection,and to analyze the effects of treatment on the expression levels of immune-related molecules Ficolin-3 and SH2 domain protein 1A(SH2D1A).Methods A total of 130 children with EBV infection admitted to our hospital from February 2018 to February 2020 were selected and divided into control group and observation group according to different treatment methods,with 65 cases in each group.The control group was given routine treatment,while the observation group was given human interferonα-1b combined with human immunoglobulin on the basis of routine treatment.The clinical symptoms of fever,cough,cervical lymph node enlargement,pharyngeal pain,tonsillar enlargement and hepatosplenomegaly were observed.Real-time fluorescence quantitative PCR(RT-qPCR)was used to detect EBV-DNA,EBV-CA-IgM and EBV-NA-IgG in the two groups before and after treatment,and enzyme-linked immunosorbent assay(ELISA)was used to detect the levels of Ficolin-3 and SH2D1A in the two groups before and after treatment.T lymphocyte subsets of CD3^(+),CD4^(+),CD8^(+)and CD4^(+)/CD8^(+)were analyzed by flow cytometry.Results The time of clinical symptoms of fever,cough,cervical lymph node enlargement,sore throat,tonsillar enlargement and hepatosplenomegaly disappearance or regression in the observation group were shorter than those in the control group,and the negative conversion rates of EBV-DNA and EBV-CA-IgM were higher than those in the control group,and the differences were statistically significant(P<0.05).Compared with before treatment,Ficolin-3,SH2D1A,IL-6,IL-8,TNF-αand CD8^(+)decreased significantly after treatment,while CD3^(+),CD4^(+)and CD4^(+)/CD8^(+)increased significantly(P<0.05).Before treatment,the expression of Ficolin-3 and SH2D1A positively correlated with IL-6,IL-8,TNF-αand CD8^(+)(r=0.478,0.454,0.503;0.462,0.443,0.511,all P<0.001),and negatively correlated with CD3^(+),CD

关 键 词：干扰素Α-1B 人免疫球蛋白 EB病毒 纤维胶凝蛋白3 SH2结构域蛋白1A 感染 

分 类 号：R725.1[医药卫生—儿科]