肺炎链球菌与呼吸道合胞病毒共感染肺炎患儿免疫细胞变化与预后的相关性  

The correlation between immune cell changes and prognosis in pediatric pneumonia caused by co-infection of Streptococcus pneumoniae and respiratory syncytial virus in children

作　　者：薛乔 赵英免 孙世心 赵英英 XUE Qiao;ZHAO Yingmian;SUN Shixin;ZHAO Yingying(Department of Pediatrics,Xingtai People's Hospital,Xingtai,Hebei 054001,China;不详)

机构地区：[1]邢台市人民医院儿二科,河北054001 [2]邢台市人民医院内分泌科,河北054001

出　　处：《中国微生态学杂志》2025年第3期318-322,共5页Chinese Journal of Microecology

基　　金：河北省2024年度医学科学研究课题计划(20241735)。

摘　　要：目的探讨肺炎链球菌与呼吸道合胞病毒(RSV)共感染对肺炎患儿外周血免疫细胞变化的影响及其与疾病预后之间的关系。方法选取2022年6月至2024年2月在我院治疗的88例肺炎患儿为研究对象,患儿分为单纯肺炎链球菌感染组(32例)、单纯RSV感染组(28例)及共感染组(28例)。检测患儿外周血中T细胞、B细胞、NK细胞、中性粒细胞及单核巨噬细胞的数量,并分析这些免疫细胞与住院时间、并发症发生率及抗生素应用时长等预后指标的相关性。结果与2个单纯感染组相比,共感染组患儿的T细胞(t=1.225,P=0.032)、B细胞(t=2.213,P<0.001)、NK细胞(t=3.205,P<0.001)、中性粒细胞(t=3.021,P<0.0001)和单核巨噬细胞(t=1.005,P=0.012)数量显著增高,其中中性粒细胞的增加最为显著。共感染组患儿的住院时间与T细胞(r=-0.515,P=0.001)和NK细胞(r=-0.467,P=0.001)呈负相关,与中性粒细胞(r=0.625,P=0.001)和单核巨噬细胞(r=0.625,P=0.024)呈正相关;并发症发生率与T细胞(r=-0.405,P=0.032)、NK细胞(r=-0.467,P=0.024)呈负相关,与中性粒细胞(r=0.425,P=0.011)和单核巨噬细胞(r=0.535,P=0.027)呈正相关;抗生素应用时长与T细胞(r=-0.515,P<0.001)和NK细胞(r=-0.467,P<0.001)呈负相关,与中性粒细胞(r=0.725,P<0.001)和单核巨噬细胞(r=0.755,P=0.024)呈正相关。结论肺炎链球菌与RSV共感染会显著影响儿童肺炎患者的免疫细胞数量,且这些变化与预后密切相关。T细胞和NK细胞数量的增加与较好的预后相关,而中性粒细胞和单核巨噬细胞的增加则与较差的预后相关,提示调节免疫细胞功能可能是改善共感染患儿预后的重要策略。Objective To observe the impact of co-infection with Streptococcus pneumoniae and respiratory syncytial virus(RSV)on peripheral blood immune cells in pediatric pneumonia patients and its relationship with disease prognosis.Methods A total of 88 children with pneumonia treated in the hospital from June 2022 to February 2024 were enrolled and divided into three groups:Streptococcus pneumoniae infection group(32 cases),RSV infection group(28 cases),and co-infection group(28 cases).The peripheral blood levels of T cells,B cells,NK cells,neutrophils and monocytes were measured,and the correlation between these immune cells and prognosis indicators such as hospital stay,complication rates and duration of antibiotic use was analyzed.Results Compared with the single infection groups,the co-infection group had significantly higher counts of T cells(t=1.225,P=0.032),B cells(t=2.213,P<0.001),NK cells(t=3.205,P<0.001),neutrophils(t=3.021,P<0.001),and monocytes(t=1.005,P=0.012),with the most notable increase observed in neutrophils.In the co-infection group,hospital stay was negatively correlated with T cell(r=-0.515,P=0.001)and NK cell(r=-0.467,P=0.001)counts,and positively correlated with neutrophil(r=0.625,P=0.001)and monocyte(r=0.455,P=0.024)counts.Complication rate was negatively correlated with T cell(r=-0.405,P=0.032)and NK cell(r=-0.467,P=0.024)counts,and positively correlated with neutrophil(r=0.425,P=0.011)and monocyte(r=0.535,P=0.027)counts.Antibiotic duration was negatively correlated with T cell(r=-0.515,P<0.001)and NK cell(r=-0.467,P<0.001)counts,and positively correlated with neutrophil(r=0.725,P<0.001)and monocyte(r=0.755,P=0.024)counts.Conclusion Coinfection with Streptococcus pneumoniae and RSV significantly impacts immune cell levels in pediatric pneumonia patients,and these changes are closely associated with prognosis.Increased T and NK cell counts are associated with better outcomes,while elevated neutrophil and monocyte counts correlate with worse outcomes,suggesting that modulating immune cell function

关 键 词：肺炎链球菌 呼吸道合胞病毒 儿童肺炎 

分 类 号：R392[医药卫生—免疫学]