异型淋巴细胞比例对传染性单核细胞增多症患儿免疫系统的影响  

The effect of the proportion of atypical lymphocytes on the immune system of children with infectious mononucleosis

作　　者：柳楚楚 钟筱英 LIU Chuchu;ZHONG Xiaoying(Department of Pediatrics,Jinhua Maternal and Child Health Care Hospital,Jinhua 321000,Zhejiang,China)

机构地区：[1]金华市妇幼保健院儿内科,浙江金华321000

出　　处：《中国现代医生》2024年第36期52-55,113,共5页China Modern Doctor

摘　　要：目的探讨异型淋巴细胞比例对传染性单核细胞增多症(infectious mononucleosis,IM)患儿免疫系统的影响。方法选取2023年5月至2024年5月金华市妇幼保健院收治的153例IM患儿作为IM组,选取同期153名健康儿童作为健康组,分析异型淋巴细胞比例与IM患儿EB病毒载量的关系。检测并比较两组纳入者的免疫系统指标[补体C3、C4、CD19^(+)细胞、T淋巴细胞亚群、免疫球蛋白(immunoglobulin,Ig)A、IgG、IgM]表达水平,分析异型淋巴细胞比例与免疫系统指标的关系。根据免疫情况将IM患儿分为严重免疫系统紊乱组、非严重免疫系统紊乱组,分析严重免疫系统紊乱IM患儿的临床特征并比较异型淋巴细胞比例差异。结果与健康组比较,IM组患儿的异型淋巴细胞比例升高(P<0.001)。Pearson检验显示异型淋巴细胞比例与IM患儿EB病毒载量呈正相关(P<0.05)。与健康组比较,IM组患儿补体C3、C4、CD8^(+)T细胞、IgA、IgG、IgM水平升高,CD4^(+)T细胞、CD4^(+)/CD8^(+)、CD19^(+)细胞降低(P<0.001)。在IM儿童中,异型淋巴细胞比例与CD4^(+)T细胞、CD4^(+)/CD8^(+)、CD19^(+)细胞呈负相关,与CD8^(+)T细胞、IgA、IgG、IgM呈正相关(P<0.05)。异型淋巴细胞比例升高是IM患儿免疫系统紊乱程度的危险因素(P<0.001)。异型淋巴细胞比例诊断IM患儿免疫系统紊乱的曲线下面积为0.918。结论IM患儿存在不同程度的免疫系统紊乱现象,以特异性免疫紊乱为主,其紊乱程度与异型淋巴细胞比例升高有关。异型淋巴细胞比例可作为早期诊断IM患儿免疫紊乱程度的参考指标。Objective To study the effect of the proportion of atypical lymphocytes on the immune system of children with infectious mononucleosis(IM).Methods 153 children with IM admitted Jinhua Maternal and Child Health Care Hospital from May 2023 to May 2024 were selected as IM group,and 153 healthy children were selected as healthy group.The relationship between the proportion of atypical lymphocytes and EB virus load in IM patients was analyzed.The expression levels of immune system indicators[complement C3,C4,CD19^(+)cells,T lymphocyte subsets,immunoglobulin(Ig)A,IgG,IgM]between two groups were detected and compared,the relationship between the proportion of atypical lymphocytes and immune system indicators was analyzed.The children with IM were divided into severe immune system disorder group and non-severe immune system disorder group according to the immune status,the clinical characteristics of children with severe immune disorder analyzed and compared the differences in the proportion of atypical lymphocytes.Results Compared with healthy group,the proportion of atypical lymphocytes in IM group increased(P<0.001).Pearson correlation test showed a positive correlation between the proportion of atypical lymphocytes and EB virus load in children with IM(P<0.05).Compared with healthy group,levels of complement C3,C4,CD8^(+)T cells,IgA,IgG and IgM were increased in IM group,while CD4^(+)T cells,CD4^(+)/CD8^(+)ratio,and CD19^(+)cells were decreased(P<0.001).In children with IM,the proportion of atypical lymphocytes was negatively correlated with CD4^(+)T cells,CD4^(+)/CD8^(+)ratio,and CD19^(+)cells,and positively correlated with CD8^(+)T cells,IgA,IgG and IgM(P<0.05).The increased proportion of atypical lymphocytes was a risk factor for the degree of immune system disorder in children with IM(P<0.001).Area under the curve for diagnosing immune system disorders in children with IM using the proportion of atypical lymphocytes was 0.918.Conclusion Children with IM exhibit varying degrees of immune system disorders,with spec

关 键 词：传染性单核细胞增多症 异型淋巴细胞比例 细胞免疫 体液免疫 免疫系统紊乱 

分 类 号：R512.7[医药卫生—内科学]