CXCR5⁺ CD8⁺ T细胞在儿童传染性单核细胞增多症中的反应特点及临床价值  

Responding Characteristics and Clinical Value of CXCR5+ CD8+ T Cells in Children with Infectious Mononucleosis

作　　者：薛健 王建勇 张晓录[2] 谷钰峰 邢海燕 辛毅 王晓莉[1] 李爱敏 

机构地区：[1]青岛大学附属烟台毓璜顶医院儿科,山东 烟台 [2]青岛大学附属烟台毓璜顶医院检验中心,山东 烟台 [3]青岛大学附属烟台毓璜顶医院变态反应科,山东 烟台

出　　处：《临床医学进展》2023年第5期8145-8155,共11页Advances in Clinical Medicine

摘　　要：目的:本研究旨在探讨C-X-C趋化因子受体5型(CXCR5) CD8+ T细胞在儿童EBV相关传染性单核细胞增多症(IM)中的反应特点及临床价值。方法:采用流式细胞术及EB病毒(EBV)病原学检查分析入组儿童的外周血,同时收集临床资料进行统计分析。结果:EBV感染急性期CXCR5+ CD8+ T细胞绝对值计数显著增加,CXCR5+ CD8+ T/CD8+ T细胞比值、CD19+ B细胞的绝对值计数及CD19+ B细胞/LYM比值显著降低。CXCR5+ CD8+ T细胞绝对值计数与EBV DNA病毒载量、CD19+ B细胞绝对值计数呈负相关与肝损伤指标呈正相关。将EBV相关性IM急性期患儿以CXCR5+ CD8+ T细胞绝对值计数中位值分为高、低表达两组,高表达组中出现淋巴结肿大、肝脾肿大的几率明显高于低表达组。ROC曲线分析显示CXCR5+ CD8+ T细胞对儿童IM具有诊断价值,对于EBV相关肝损伤具有预测价值。结论:CXCR5+ CD8+ T细胞在EBV的急性感染中发挥了抗病毒作用,而其过度反应可能导致组织器官损伤。此外,CXCR5+ CD8+ T细胞可作为EBV相关IM诊断的诊断指标及EBV相关性肝损伤的预测指标。Objective: To investigate the response characteristics and clinical value of C-X-C chemokine receptor type 5 (CXCR5) CD8+ T cells in children with EBV-associated infectious mononucleosis (IM). Methods: Peripheral blood of the enrolled children was analyzed by flow cytometry and Epstein-Barr virus (EBV) etiology, and clinical data were collected for statistical analysis. Results: The absolute number of CXCR5+ CD8+ T cells increased significantly, the CXCR5+ CD8+ T/CD8+ T cell ratio, the absolute number of CD19+ B cells and the CD19+ B cell/LYM ratio decreased significantly in the acute stage of EBV infection. The absolute number of CXCR5+ CD8+ T cells was negatively correlated with EBV DNA load and absolute number of CD19+ B cells, and positively correlated with liver injury index. The children in the acute stage of EBV-associated IM were divided into high and low expression groups according to the median value of CXCR5+ CD8+ T cells absolute number. The probability of lym-phadenectasis, hepatosplenomegaly in the high expression group was significantly higher than that in the low expression group. ROC curve analysis showed that CXCR5+ CD8+ T cells had diagnostic value in EBV-associated IM, and had predictive value in EBV-related liver injury. Conclusion: CXCR5+ CD8+ T cells act as an antiviral role in acute infection of EBV, and their overreaction may lead to tis-sue and organ damage. In addition, CXCR5+ CD8+ T cells can be used as diagnostic indicators of EBV-associated IM and predictive indicators of EBV-associated liver injury.

关 键 词：CXCR5⁺ CD8⁺ T细胞 EBV相关性IM 流式细胞术 EBV相关性肝损伤 

分 类 号：R73[医药卫生—肿瘤]