儿童支气管肺炎免疫细胞分布特征及其与气道高反应性的相关分析  

Analysis of the distribution characteristics of immune cells in pediatric bronchopneumonia and its correlation with airway hyperreactivity

作　　者：杨妮 陈柳娟[2] YANG Ni;CHEN Liujuan(Department of Nutrition,Liuzhou People's Hospital,Liuzhou 545026,China;Department of Pediatrics,Liuzhou People's Hospital,Liuzhou 545026,China)

机构地区：[1]柳州市人民医院营养科,545026 [2]柳州市人民医院儿科,545026

出　　处：《免疫学杂志》2024年第12期893-900,共8页Immunological Journal

摘　　要：目的探讨支气管肺炎患儿免疫细胞分布特征及其与气道高反应性的关系。方法选取2019年1月至2022年1月期间本院收治的600例支气管肺炎住院患儿为研究对象,依据是否发生气道高反应性分为气道正常组(n=286)和气道高反应组(n=314),比较2组患儿的临床资料。对比治疗前后2组免疫细胞(CD3^(+)、CD3^(+)CD4^(+)、CD3^(+)CD8^(+)、CD4^(+)/CD8^(+))以及呼吸道反应指标(呼吸阻力、反应阈值、阻力上升斜率)变化,并进一步进行各组组内比较分析。采用Log-binomial模型分析不同免疫细胞与不同致病菌气道高反应性的风险效应,采用多因素Logistics回归分析气道高反应性的影响因素。结果2组免疫细胞(CD3^(+)、CD3^(+)CD4^(+)、CD3^(+)CD8^(+)、CD4^(+)/CD8^(+))以及呼吸道反应指标(呼吸阻力、反应阈值、阻力上升斜率)存在显著差异(P<0.05);CD3^(+)、CD3^(+)CD4^(+)、CD3^(+)CD8^(+)、CD4^(+)/CD8^(+)、EGFR、hs-CRP、IL-10、CXCL13、HSP90、Ig G、Ig A是支气管肺炎患儿气道高反应性的独立影响因素(P<0.01);有CD3^(+)CD8^(+)特征的患者出现革兰氏阴性菌感染的风险最高,是无高反应性的1.83倍,有CD3^(+)CD4^(+)特征的患者出现革兰氏阴性菌感染的风险最低,是无高反应性患者的1.31倍;有CD3^(+)CD8^(+)特征的患者出现革兰氏阳性菌感染的风险最高,是稳定型的1.81倍,有CD3^(+)CD4^(+)特征的患者出现革兰氏阳性菌感染的风险最低,是稳定型患者的1.22倍。结论本研究不仅揭示了儿童支气管肺炎免疫细胞分布特征与气道高反应性之间的密切关系,还确定了多个独立影响因素,并初步探讨了免疫细胞特征与感染风险的关系。Objective To investigate the distribution of immune cells in children with bronchopneumonia and its relationship with airway hyperreactivity.Methods A total of 600 hospitalized children with bronchopneumonia admitted to our hospital from January 2019 to January 2022 were selected as the study objects.They were divided into normal airway group(n=286)and airway hyperreaction group(n=314)according to whether airway hyperreactivity occurred.Clinical data of the two groups were compared.The changes of immune cells(CD3^(+),CD3^(+)CD4^(+),CD3^(+)CD8^(+),CD4^(+)/CD8^(+))and respiratory tract response indicators(respiratory resistance,response threshold,resistance rise slope)before and after treatment were compared between the two groups,and the intra-group comparison analysis was further conducted.Log-binomial model was used to analyze the risk effect of airway hyperreactivity of different immune cells and different pathogens,and multi-factor Logistics regression was used to analyze the influencing factors of airway hyperreactivity.Results There were significant differences in immune cells(CD3^(+),CD3^(+)CD4^(+),CD3^(+)CD8^(+),CD4^(+)/CD8^(+))and respiratory tract response indexes(respiratory resistance,response threshold,resistance rise slope)between the two groups(P<0.05).CD3^(+),CD3^(+)CD4^(+),CD3^(+)CD8^(+),CD4^(+)/CD8^(+),EGFR,hs-CRP,IL-10,CXCL13,HSP90,IgG and IgA were the independent influencing factors of airway hyperresponsiveness in children with bronchial pneumonia(P<0.01).Patients with CD3^(+)CD8^(+)characteristics had the highest risk of gram-negative bacteria infection,which was 1.83 times higher than those without hyperreactivity.Patients with CD3^(+)CD4^(+)characteristics had the lowest risk of gram-negative bacteria infection,which was 1.31 times higher than those without hyperreactivity.Patients with CD3^(+)CD8^(+)characteristics had the highest risk of gram-positive infection,1.81 times higher than those with stable types,and patients with CD3^(+)CD4^(+)characteristics had the lowest risk of gram-positi

关 键 词：儿童支气管肺炎 免疫细胞 气道高反应 T淋巴细胞 

分 类 号：R725.6[医药卫生—儿科]